“Cerebral angiography”的意思、由来-开放百科全书

Cerebral angiography is a form of angiography which provides images of blood vessels in and around the brain, thereby allowing detection of abnormalities such as arteriovenous malformations and aneurysms.

It was pioneered in 1927 by the Portuguese neurologist Egas Moniz at the University of Lisbon, who also helped develop thorotrast for use in the procedure.^[1]

Typically a catheter is inserted into a large artery (such as the femoral artery) and threaded through the circulatory system to the carotid artery, where a contrast agent is injected. A series of radiographs are taken as the contrast agent spreads through the brain's arterial system, then a second series as it reaches the venous system.

Prior to the 1970s the typical technique involved a needle puncture directly into the carotid artery,^[2]^[3] as depicted in the 1973 horror film The Exorcist,^[4] which was replaced by the current method of threading a catheter from a distant artery due to common complications caused by trauma to the artery at the puncture site in the neck (particularly hematomas of the neck, with possible compromission of the airway).^[5]^[6]

For some applications{{Citation needed|date=December 2009}} cerebral angiography may yield better images than less invasive methods such as computed tomography angiography and magnetic resonance angiography.

In addition, cerebral angiography allows certain treatments to be performed immediately, based on its findings. In recent decades, cerebral angiography has so assumed a therapeutic connotation thanks to the elaboration of endovascular therapeutic techniques. Embolization (a minimally invasive surgical technique) over time has played an increasingly significant role in the multimodal treatment of cerebral MAVs, facilitating subsequent microsurgical or radiosurgical treatment.^[7]^[8] Another type of treatment possible by angiography (if the images reveal an aneurysm) is the introduction of metal coils through the catheter already in place and maneuvered to the site of aneurysm; over time these coils encourage formation of connective tissue at the site, strengthening the vessel walls.^[9]^[10]

In some jurisdictions, cerebral angiography is required to confirm brain death.{{Citation needed|date=December 2009}}

Prior to the advent of modern neuoroimaging techniques such as MRI and CT in the mid-1970s, cerebral angiographies were frequently employed as a tool to infer the existence and location of certain kinds of lesions and hematomas by looking for secondary vascular displacement caused by the mass effect related to these medical conditions. This use of angiography as an indirect assessment tool is nowadays obsolete as modern non-invasive diagnostic methods are available to image many kinds of primary intracranial abnormalities directly.^[11] It is still widely used however for evaluating various types of vascular pathologies within the skull.

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1. ^Tondreau, R. (1985) Egas Moniz 1874-1955. Radiographics, 5(6):994-997
2. ^{{cite journal |vauthors=Nii K, Kazekawa K, Onizuka M, Aikawa H, Tsutsumi M, Tomokiyo M, Iko M, Kodama T, Matsubara S, Go Y, Tanaka A |title=Direct carotid puncture for the endovascular treatment of anterior circulation aneurysms |journal=AJNR Am J Neuroradiol |volume=27 |issue=7 |pages=1502–4 |date=August 2006 |pmid=16908568 |doi= |url=http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=16908568 |accessdate=2018-03-20}}
3. ^{{cite journal |vauthors=Ross IB, Luzardo GD |title=Direct access to the carotid circulation by cut down for endovascular neuro-interventions |journal=Surg Neurol |volume=65 |issue=2 |pages=207–11; discussion 211 |date=February 2006 |pmid=16427431 |doi=10.1016/j.surneu.2005.06.023 }}
4. ^{{cite book |last1=Harrigan |first1=Mark R. |last2=Deveikis |first2=John P. |title=Handbook of Cerebrovascular Disease and Neurointerventional Technique |date=April 20, 2009 |publisher=Springer Science & Business Media|isbn=9781603271257|page=88|url=https://books.google.com/books?id=QrPkX8eCHEIC&pg=PA88|accessdate=February 23, 2019}}
5. ^{{cite journal |vauthors=Taha MM, Sakaida H, Asakura F, Maeda M, Toma N, Sano T, Hori K, Matsushima S, Taki W |title=Access site complications with carotid angioplasty and stenting |journal=Surg Neurol |volume=68 |issue=4 |pages=431–7 |date=October 2007 |pmid=17905068 |doi=10.1016/j.surneu.2006.11.036 }}
6. ^{{cite journal|author1=Palmer, F. J.|author2=Sorby, W. A.|title=Carotid Angiography By Direct Needle Puncture An Obsolete Technique|journal=Australasian Radiology|date=March 1975|volume=19|issue=1|page=26–31|doi=10.1111/j.1440-1673.1975.tb01915.x}}
7. ^{{cite journal |vauthors=Valavanis A, Yaşargil MG |title=The endovascular treatment of brain arteriovenous malformations |journal=Adv Tech Stand Neurosurg |volume=24 |issue= |pages=131–214 |date=1998 |pmid=10050213 |doi= }}
8. ^{{cite journal |vauthors=Negoro M, Miyachi S, Hattori T, Okamoto T, Fukui K, Fukasaku KA, Iwakoshi T, Yoshida J |title=The selection and result of AVM treatment |journal=Interv Neuroradiol |volume=5 Suppl 1 |issue= |pages=167–70 |date=November 1999 |pmid=20670560 |doi=10.1177/15910199990050S130 }}
9. ^{{cite journal |vauthors=Söderman M, Andersson T, Karlsson B, Wallace MC, Edner G |title=Management of patients with brain arteriovenous malformations |journal=Eur J Radiol |volume=46 |issue=3 |pages=195–205 |date=June 2003 |pmid=12758114 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0720048X03000913 |accessdate=2018-03-20}}
10. ^{{cite journal |vauthors=Briganti F, Leone G, Panagiotopoulos K, Marseglia M, Mariniello G, Napoli M, Caranci F |title=Endovascular treatment of cerebral aneurysms using the hydrocoil embolic system |journal=Neuroradiol J |volume=26 |issue=4 |pages=420–7 |date=August 2013 |pmid=24007730 |pmc=4202812 |doi=10.1177/197140091302600407 }}
11. ^{{cite journal |last1=Leeds |first1=NE |last2=Kieffer |first2=SA |title=Evolution of diagnostic neuroradiology from 1904 to 1999. |journal=Radiology |date=November 2000 |volume=217 |issue=2 |pages=309–18 |doi=10.1148/radiology.217.2.r00nv45309 |pmid=11058623 |url=https://pdfs.semanticscholar.org/8bfc/17f6ff7c70706ad0ad25b382558088463a2c.pdf}}

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