gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Results of diffusion-weighted MR-Imaging after intra-arterial digital subtraction angiography (i.a.-DSA), and aneurysm-treatment by either coiling or clipping

Ergebnisse diffusions-gewichteter MR-Untersuchungen nach intra-arterieller digitaler Subtraktions-Angiographie (i.a.-DSA) und Aneurysma-Behandlung entweder durch Coiling oder Clipping

Meeting Abstract

  • corresponding author Maximilian J. A. Puchner - Neurochirurgische Klinik, Krankenanstalten Gilead, Bielefeld
  • M. Martins - Neurochirurgische Klinik, Krankenanstalten Gilead, Bielefeld
  • U. Dietrich - Abteilung für Neuroradiologie, Krankenanstalten Gilead, Bielefeld
  • F. Oppel - Neurochirurgische Klinik, Krankenanstalten Gilead, Bielefeld

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.09.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0092.shtml

Veröffentlicht: 23. April 2004

© 2004 Puchner et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Diffusion-weigthed MR-Imaging (DWI) show a diminished diffusion-ability of protons and thereby allow an early and very sensitive detection of cerebral ischemia. Previous studies showed, that areas of diffusion-disturbances (= ischemic foci) occur in 25% of patients undergoing cerebral i.a.-DSA and 60% of those treated by aneurysm-coiling. The aim of the present study was to examine, which variables are influencing the rate of diffusion-disturbances after i.a.-DSA and whether diffusion disturbances can also be detected after clipping of aneurysms.

Methods

Since March 2003 all patients of our hospital who underwent i.a.-DSA or who were treated for a cerebral aneurysm either by coiling or clipping (only Grade 0-2, H&H), were examined by DWI 24-72 hours after the procedure. The MR-sequences and parameters used were TE 105 ms, TR 4978 ms, SL 5 mm, AC 2, b=1000. The examined parameters possibly influencing the rate of diffusion-disturbances were: patients' age, examiner, time and duration of examination, number of contrast-injections.

Results

Diffusion-disturbances were observed after i.a.-DSA in 34% of 44 patients examined. A higher experience of the examiner and a lower patients' age were associated with a lower rate of diffusion-disturbances. The other parameters did not influence the occurrence of diffusion-disturbances. Diffusion disturbances after coiling were observed in 6 out of 11 patients (55%) whereas after clipping in two out of 14 patients (14%).

Conclusions

Diffusion-disturbances after endovascular procedures occur comparably often and are depending on the experience of the examiner and the patients' age which is correlating to the state of the vascular intima. The pure external manipulation on arteries, as necessary in aneurysm-surgery, does obviously not induce diffusion-disturbances unless a vascular obstruction (stroke) could not prevented.