IVR-CT/angio systemを用いた血管内手術手技中の脳循環評価

Evaluation of Cerebral Blood Perfusion with IVR-CT/Angio System during Interventional Procedures

Ⅰ．は じ め に

　Interventional radiology（IVR）は，近年のさまざまなディバイスの発達から急速に普及してきている．血管撮影装置に computed tomography（CT）を併設したシステム（IVR-CT/angio system：Advantx ACT，GE メディカルシステム）は，1つの検査テーブルを用いて，脳血管撮影とCTによる頭蓋内スクリーニングを行うことができる装置である．脳血管内手術においては，患者の移動を行うことなく，術中，術後に迅速にCTを行うことができ，さらにCT perfusion（以下，CTP）を行うことで，安全に脳循環評価を行うことも可能となる．今回このシステムを用いたIVR手技中の脳循環評価方法について報告する．

An interventional-radiology computed-tomography (IVR-CT)/angio system is a combination of an angiographic unit and a CT scanner. This system allows patient's movement in and out of the two imaging units, on the same table. Since June 2003, we have applied our conventional protocol for evaluation of cerebral blood perfusion during interventional radiology (IVR) procedures. We reviewed our experience using the IVR-CT/angio system and investigated the efficacy and limitations of this technique. No complications relating to radiation exposure, contrast medium use, or IVR procedures were observed. CT perfusion was useful for detecting cerebral perfusion impairment during IVR procedures. This was helpful in deciding the postoperative management. Because patients do not need to be transported to another radiographic suite to evaluate cerebral blood perfusion, the IVR-CT/angio system is ideal for safely and simply detecting cerebral perfusion defects during IVR procedures. However, it is important to consider whether there is sufficient indication for the procedure, because radiation exposure and the amount of contrast medium use are increased if the IVR procedures become difficult.