Infundibular dilation: an anatomical variant or a pre-aneurysm? Advantages of assessment with three-dimensional rotational angiography

Abstract

The 3DRA with VR appears superior to 2DRA for both diagnosing IDs and displaying the anatomical relationship between IDs and aneurysms. The findings also suggest that some IDs might progress to aneurysms or become a part of them, which should be carefully evaluated prior to operation.

Ptosis as Partial Oculomotor Nerve Palsy Due to Compression by Infundibular Dilatation of Posterior Communicating Artery, Visualized with Three-Dimensional Computer Graphics: Case Report

“… 14 , 16 – 18) In general, ID is considered to be a normal anatomic variant of no pathogenic significance. 19 , 20) On the other hand, IDs have undergone aneurysmal development and rupture. 13 , 19 , 21 – 23) Mechanical compression of cranial nerves by unruptured ID is extremely rare.…”

An infundibulum of thalamoperforator arteries: Importance of angiographic images for appropriate diagnosis

“…[68] Although Salkman's initial description addressed only PcomA infundibula, the dilatations have also been detected at branching sites of the AChoA. [19] The typical infundibulum has a widening of pyramidal shape, with its base facing the parent artery and measuring ≤3 mm, and its apex giving rise to the branching artery (generally the PcomA or AChoA). [8] In areas rich in perforating vessels, such as the P1 segment of the PCA and the M1 segment of the MCA, infundibular dilatations may incorporate the origin of more than one perforator, giving the infundibulum a double-peaked shape, rather than the more conical form typically associated with an infundibulum.…”

“…Three-dimensional rotational angiography with volume rendering has shown superiority to 2D angiography in diagnosis of both cerebral aneurysms and infundibular dilatations. [19] Interpretation of 3D images acquired during rotational angiography should be done cautiously in conjunction with the 2D angiography to exclude potential artifacts resulting from the 3D reconstruction processing. [19]…”

“…[19] Interpretation of 3D images acquired during rotational angiography should be done cautiously in conjunction with the 2D angiography to exclude potential artifacts resulting from the 3D reconstruction processing. [19]…”

“…Although for most clinicians the typical infundibular dilatations have minimal pathogenic significance and risks, some authors consider them to be pre-aneurysmal lesions. [14141617192122] Documentation of evolution from an infundibulum to an aneurysm with subsequent rupture is present, although scant in the literature. [1414162122] Among the reported cases, progression to aneurysm occurred between 0.5 and 9 years following the diagnosis of infundibulum.…”