RESUMO
Recent advances in digital subtraction angiography(DSA)and 3D-CT angiography(3D-CTA)have enabled the identification of tiny intracranial aneurysms. However, the imaging of blood blister-like aneurysms(BBAs)in the internal carotid artery(ICA)is still challenging. We report the case of a subarachnoid hemorrhage(SAH)with a ruptured BBA in the ICA that was revealed by magnetic resonance vessel wall imaging(MR-VWI). A 68-year-old woman presented with SAH. CT showed diffuse SAH(Fisher group 3). 3D-CTA and DSA showed a small bulge in the right ICA. MR-VWI with gadolinium showed thick wall enhancement in the supraclinoid portion of the right ICA; hence, we diagnosed SAH because of the ruptured BBA of the right ICA. Trapping combined with high-flow bypass was performed for the ruptured BBA. We concluded that MR-VWI may be useful for diagnosing ruptured BBAs under strict blood pressure management.
Assuntos
Aneurisma Roto , Aneurisma Intracraniano , Hemorragia Subaracnóidea , Idoso , Aneurisma Roto/complicações , Aneurisma Roto/diagnóstico por imagem , Artéria Carótida Interna , Angiografia Cerebral , Feminino , Humanos , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/diagnóstico por imagem , Espectroscopia de Ressonância Magnética , Hemorragia Subaracnóidea/etiologiaRESUMO
The design and construction of a new type of time-of-flight mass spectrometer is described. The instrument was designed to improve the ionization efficiency and to efficiently detect ions. The system performance was evaluated using the SIMION software, and was compared with the experimental results. The shapes of the repeller, extraction, and ground electrodes had a strong effect on the trajectory of ions in the processes of ion acceleration and focusing. The major difference between the theory and the experiment can be attributed to space-charge effects.