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Neurological Surgery No Shinkei Geka Volume 20, Issue 10 （October 1992）

Neurological Surgery 脳神経外科 20巻10号（1992年10月発行）

Japanese English

研究

Phase Contrast Angiographyの臨床応用について Clinical Application of Phase Contrast Angiography 松沢等 ¹ , 宝金清博 ¹ , 野村三起夫 ¹ , 上山博康 ¹ , 岩崎喜信 ¹ , 阿部弘 ¹ , 秋野実 ² , 斉藤久寿 ² Hitoshi MATSUZAWA ¹ , Kiyohiro HOUKIN ¹ , Mikio NOMURA ¹ , Hiroyasu KAMIYAMA ¹ , Yoshinobu IWASAKI ¹ , Hiroshi ABE ¹ , Minoru AKINO ² , Hisatoshi SAITO ² ¹北海道大学脳神経外科 ²札幌麻生脳神経外科病院 ¹Department of Neurosurgery, Hokkaido University School of Medicine ²Sapporo Azabu Neurosurgical Hospital キーワード： Magnetic resonance imaging , Magnetic resonance angiography , Cerebrovascular disease , Spinal vascular disease Keyword: Magnetic resonance imaging , Magnetic resonance angiography , Cerebrovascular disease , Spinal vascular disease pp.1049-1054

発行日 1992年10月10日 Published Date 1992/10/10

DOI https://doi.org/10.11477/mf.1436900535

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Abstract 文献概要
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I．はじめに

　中枢神経系の画像診断に欠くべからざる手段としてMagnetic Resonance Imaging（以下MRI）はすでにその地位を確立している．そのうち特に，血管だけの描出を目的とした画像に磁気共鳴血管造影，MR-angiography（以下MRA）がある．MRAの手法には大きく分けて2つの種類，time of flight angiographyとphase contrastangiographyがあり，その簡便さゆえに，一般には前者のtime of flight angiographyが多用されているが，われわれは後者のphase contrast angiographyについて，特に3—dimensional phase contrast angiographyをもちいて頭蓋内血管病変および脊髄血管病変について臨床応用を試み，良好な結果を得たので報告する．

“Phase Contrast Angiography” is a new technique of Magnetic Resonance Angiography as reported by Dumoulin CL et al. Using this technique, we can obtain images of vessels (angiograms) without injection of con-trast medium.

We present the results of phase contrast angiography on cerebral and spinal vascular disease.

We utilized the General Electric SIGNA, 1.5 tesla NMR. One hundred and ninety-one cases of cerebral and spinal vascular diseases were scanned using phase con-trast angiography. Included were 90 cases of occlusive vascular disease, 16 cases of moyamoya disease, 39 cases of arteriovenous malformation, and 28 aneurysms. The phase contrast angiography uses flow encoding gradient pulses, which impart a velocity-dependent phase shift to the transverse magnetization of moving spins. The re-sulting image contains only information from the moving spins ; while information from stationary tissue remains suppressed. In cases using 3-D angiogram, we made 32images 6 degrees apart in their projection direction and displayed them on a video terminal.

We were able to visualize occlusions of vessels, aneurysms, bypassed vessels, and abnormal vessels of arteriovenous malformations. Retrospective evaluation comparing phase contrast angiography with convention-al angiography of the stenotic findings on the horizontal portion of middle cerebral arteries (64 vessels of 32 pa-tients), resulted in a false positive ratio of 39.1%. We obtained clinically valuable results regarding the hydrodynamics of patients using “phase contrast angiography” non-invasively. These results reveal not only “anatomical” images of vessels, but also “function-al” images, which are sensitive to the pattern of the blood flow. This study would strongly suggest that phase contrast angiography presents a valuable tool for the clinical diagnosis of cerebral and spinal vascular dis-eases.