目的:高分辨率磁共振成像(HR-MRI)可以为评估血管病理状况提供有价值的见解,和3D数字减影血管造影(3D-DSA)提供了血管形态和血流动力学的清晰可视化。本研究旨在通过融合HR-MRI和3D-DSA的图像数据,探讨多模式方法治疗未破裂椎动脉夹层动脉瘤(u-VADAs)的潜力。
方法:这项观察性研究纳入了5例诊断为u-VADAs的患者,他们被安排进行介入治疗。采用几何软件对HR-MRI和3D-DSA图像数据进行融合,产生了一个多模态模型。动脉瘤壁增强(AWE)的定量值,壁面剪应力(WSS),颈部速度,流入量,支架内流速(ISvelocity),和动脉瘤内速度(IAspeed)通过多模式方法计算。
结果:我们发现多模态模型中u-VADAs的实际长度比3D-DSA模型更长。我们根据WSS制定了手术计划,IA速度,和颈部速度。IAvelocity的术后值,颈部速度,与手术前相比,AWE的随访量化值均降低。之后,在术后第6个月的随访中,u-VADAs在四名患者中完全闭塞,在一名患者中几乎完全闭塞。
结论:结合HR-MRI和3D-DSA的多维方法可能为治疗VADAs提供更有价值的信息,有可能制定有效的手术计划。
OBJECTIVE: High-resolution magnetic resonance imaging (HR-MRI) can provide valuable insights into the evaluation of vascular pathological conditions, and 3D digital subtraction angiography (3D-DSA) offers clear visualization of the vascular morphology and hemodynamics. This study aimed to investigate the potential of a multimodal method to treat unruptured vertebral artery dissection aneurysms (u-VADAs) by fusing image data from HR-MRI and 3D-DSA.
METHODS: This observational study enrolled 5 patients diagnosed with u-VADAs, who were scheduled for interventional treatment. The image data of HR-MRI and 3D-DSA were merged by geometry software, resulting in a multimodal model. Quantified values of aneurysm wall enhancement (AWE), wall shear stress (WSS), neck velocity, inflow volume, intra-stent flow velocity (ISvelocity), and intra-aneurysmal velocity (IAvelocity) were calculated from the multimodal method.
RESULTS: We found the actual lengths of u-VADAs in the multimodal model were longer than the 3D-DSA model. We formulated surgical plannings based on the WSS, IA velocity, and neck velocity. The post-operative value of IAvelocity, neck velocity, and follow-up quantified values of AWE were decreased compared with the pre-operative condition. After that, u-VADAs were complete occlusion in four patients and near-complete occlusion in one patient during the 6th-month follow-up after surgery.
CONCLUSIONS: The multidimensional method combining HR-MRI with 3D-DSA may provide more valuable information for treating VADAs, with the potential to develop effective surgical planning.