ABSTRACT
Objective To assess the technical feasibility and efficacy of the combined application of a flexible,self-expanding neurovascular stent(Neuroform)and Gugliebni detachable coils(GDC)in the management of wide-necked intracranial aneurysms in humans.Methods Sixty-five wide-necked aneurysms which underwent 65 endovascular procedures were performed by using intracranial stent and GDC.There was a total of 30 aneurysms at basilar artery including 16 at the basilar tip,9 at the basilar trunk and 5 at the beginning of the basilar artery.And there were 30 aneurysms located at the posterior communicating artery, and 5 aneurysms located at the vertebral artery.The Neuroform stents were deployed to cover the neck of aneurysms.Another microcatheter was introduced into the aneurysm sac through the stent interstices and then detachable coils were released to embolize the aneurysms.Results The combined procedures were successful in all of the 65 patients with wide-necked aneurysms.The stent could pass smoothly through the intracranial artery and got released.Complete occlusion was achieved in 60 patients and incomplete occlusion in 5 patients.In-stent thrombosis occurred in 2 patients.All patients recovered well.Forty-two patients had followe-up angiography at 3 to 6 months after the procedure.Among them,no filling was found for the 39 aneurysms which were densely packed,and 3 aneurysms had neck remnant.Conclusion The implantation of Neuroform stent as a complimentary device to GDC coiling is easy and safe for embolization of wide-necked intracranial aneurysms.It has great advantage for treatment of wide-necked intracranial aneurysms.
ABSTRACT
Objective To discuss the value of vivo proton MR spectroscopy,perfusion and diffusion imaging in grading of diffuse astrocytomas.Methods One hundred fifty-four cases with diffuse astrocytomas proved pathologically were collected.35 cases with diffuse astrocytomas including 8 astrocytomas(WHO grade Ⅱ),13 anaplastic astroeytomas(grade Ⅲ)and 14 glioblastoma muhiforms (grade Ⅳ)underwent MR spectroscopy.The Cho/Cr,NAA/Cr and Lac/Cr of three groups in 35 cases were compared.The other 76 cases including 36 low-grade glial tumors(grade Ⅱ),20 anaplastic glial tumors (grade Ⅲ)and 20 glioblastoma multiforms(grade Ⅳ)underwent conventional MR imaging and dynamic contrast-enhanced perfusion MR imaging before surgical resection or stereotactic biopsy,the characteristics of the curve and the value of the maximum relative regional cerebral volume(rrCBV)in the diffuse astrocytomas with various grades were analysed.Fourty-three cases of diffuse astrocytomas including 26 astrocytomas(grade Ⅱ),6 anaplastic astrocytomas(grade Ⅲ)and 11 glioblastoma multiformes (grade Ⅳ)underwent diffusion MRI and the apparent diffusion coefficient rate(ADCR)were compared. Results The Cho/Cr of diffuse astrocytomas in three grades were 2.709?1.228,5.812?2.374 and 5.289?1.462 respectively.There were statistically significant differences between astrocytomas and anaplastic astrocytomas,astrocytomas and glioblastoma multiformes for Cho/Cr(P0.05).The Lac/Cr of diffuse astrocytomas in three groups were 0.100?0.083,1.879?1.595 and 3.656? 2.195 respectively,the differences among three groups were all significant(P0.05).The maximum rrCBV values of glial tumors with Ⅱ,Ⅲ and Ⅳ grade were 1.379?0.739,2.654?1.072,3.218?1.565 respectively and the differences among them were statistically significant(P