未破裂中大脳動脈瘤の外科治療を安全に行うための工夫 : MRA・MRI fusion 画像の応用

Fusion imaging of magnetic resonance angiography (MRA) and MR imaging (MRI) is valuable to assess the location of the horizontal portion of the middle cerebral artery (MCA), MC bifurcation aneurysm (AN) and limen insulae. In this study, we evaluated the usefulness of fusion imaging in MC bifurcation aneurysm surgery. Between October 2007 and February 2008, 18 patients underwent clipping for unruptured MC bifurcation ANs at the authors’ institution. Preoperatively, 3DFSPGR MRI and 3DSPGR MRA data were fused. The distance of limen insulae and distal end of the horizontal portion of MCA were calculated. The mean distance in 9 distal approaches was ＋4.3±1.8 mm and －7.2±6.3 mm in 9 superior approaches, respectively. Preoperative simulation images were coincident with operative findings in all cases. Fusion images of MRA and MRI are useful for planning the treatment of unruptured MCA ANs.