著者

Kampei SHIMIZU Mika KUSHAMAE Tomohiro AOKI

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.59, no.7, pp.257-263, 2019 (Released:2019-07-15)

参考文献数

48

被引用文献数

6 13

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Considered with a poor outcome of subarachnoid hemorrhage due to rupture of intracranial aneurysms (IAs), treatment interventions to prevent rupture of the lesions are mandatory for social health. As treatment option is limited to surgical manipulations, like microsurgical clipping, endovascular coiling or deployment of flow diverter, and these surgical interventions have a potential risk of complications in nature, a proper selection of rupture-prone IAs among ones incidentally found is essential. Today, a rupture risk in each case is estimated by several factors like patient characteristics and morphological ones of each lesion. However, unfortunately, an IA without treatment sometimes unexpectedly ruptures resulting in a devastating outcome or an IA surgically treated is turned out to have a thick wall. To achieve more efficient treatment interventions, the development of a novel diagnostic modality is required. Here, mainly through the accumulation of experimental findings, the crucial contribution of macrophage-mediated chronic inflammatory responses to IA progression have been revealed, making macrophage being a promising target for a diagnosis. If we could non-invasively visualize accumulation of macrophages in lesions, this imaging technique ‘macrophage imaging’ may enable a qualitative evaluation of IAs to stratify rupture-prone ‘dangerous’ lesions among many stable ones. Thereby, a development of macrophage imaging makes an indication of surgical interventions being more accurate and also greatly facilitates a development of a novel medical therapy if used as a surrogate marker.

著者

Motoaki FUJIMOTO Shoichi TANI Hideki OGATA Kampei SHIMIZU Shota YOSHIDA Satoko YAMAGUCHI Yoshihito HIRATA Yoshinori AKIYAMA

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.2022-0246, (Released:2023-01-20)

参考文献数

19

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To improve the success of mechanical thrombectomy, three-dimensional turbo spin-echo (3D-TSE) sequences on T2WI can be employed to estimate the vascular structure of the posterior circulation. In addition to the short imaging time of 3D-TSE T2WI (33 sec), it can visualize the outer diameter of the main cerebral artery, including the occluded vessels. However, to date, the efficacy of mechanical thrombectomy in the posterior circulation remains unclear, and safer and more efficient mechanical thrombectomy procedures are required. Assessment of the anatomical variations in the posterior circulation using 3D-TSE T2WI is valuable for access decisions, device selection, and safe device guidance and retrieval techniques to the target vessel. Herein, we present representative cases of basilar artery and posterior cerebral artery occlusions in our institute and describe the utility of preoperative 3D-TSE T2WI in these patients.