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1.
目的讨论三维16层螺旋CT血管造影术(3D—CTA)诊断及评价颅内动脉瘤的应用价值,并与数字减影血管造影术(DSA)进行对比研究。方法对怀疑颅内动脉瘤的76例蛛网膜下腔出血患者(其中男性35例,女性41例,年龄38~83岁,平均年龄60.5岁)行3D-CTA检查及DSA检查。重建方法采用多平面重建(MPR)、最大密度投影(MIP)和容积透视(VR)等。通过3D-CTA确定动脉瘤的数目、位置、大小、与周围血管关系及是否有血栓和钙化等信息,并与DSA对比评价3D-CTA诊断动脉瘤的敏感性及特异性。结果3D—CTA共发现62例患者的68个动脉瘤,根据DSA的检查结果,发现1例动脉瘤被3D—CTA漏诊。在位置、大小等方面,3D—CTA与DSA及手术所见有较高的一致性,而3D—CTA显示空间征象、血栓和钙化的能力明显高于DSA。结论3D—CTA对颅内动脉瘤具有高度的敏感性和特异性,快捷、无创,可代替DSA来进行筛查及术前评估颅内动脉瘤。  相似文献
2.
3D—CTA与3D—DSA对颅内后循环动脉瘤影像诊断的比较研究   总被引:3,自引:0,他引:3  
目的比较三维螺旋CT血管造影术(3D—CTA)和三维数字减影血管造影术(3D—DSA)在颅内后循环动脉瘤诊断及介入治疗中的应用价值。方法选择天津市环湖医院2007年1月至2008年3月就诊的后循环动脉瘤所致的自发性蛛网膜下腔出血(SAH)患者164例,其中男性26例,女性138例,年龄21~80岁,平均年龄53.4岁。行3D—CTA、3D—DSA检查,研究并比较它们的CTA和DSA影像特点。结果164例后循环动脉瘤患者中共213个病灶,其中后交通动脉瘤115个,小脑后下动脉瘤19个,椎基底交界及基底动脉瘤18个,椎动脉颅内段动脉瘤9个,大脑后动脉瘤3个,小脑上动脉和小脑前下动脉瘤各2个。3D—DSA与3D—CTA准确性比较,差异无统计学意义。结论对动脉瘤应用血管内栓塞治疗时,在三维影像指导下可提高动脉瘤的致密填塞率。但是在三维影像的测量值要大于二维影像的测量值。  相似文献
3.
目的比较旋转数字减影血管造影(digitalsubtraction angiography,DSA)与磁共振血管成像(magnetic resonance angiography,MRA)在颅内动脉瘤诊断中的价值。方法40例疑为颅内动脉瘤的患者同时行旋转DSA和MRA检查。评估旋转DSA显示动脉瘤的个数、部位、大小、形态、动脉瘤颈及与载瘤动脉的关系,并与MRA进行比较分析。结果40例患者共40个动脉瘤,旋转DSA检查发现39个,敏感性为97.5%,直径大小为2~30mm。MRA检查发现36个,敏感性为90%,直径大小为4-30mm。旋转DSA检查对动脉瘤的全貌、瘤颈的位置和结构及与周围血管分支的解剖关系均能清晰显示。旋转DSA显示动脉瘤的部位、大小和形态同MRA基本一致。结论旋转DSA技术在颅内动脉瘤诊断和治疗中具有极其重要的作用,在敏感性和特异性方面优于MRA,不但可明确诊断,而且还有利于临床治疗方式的选择。  相似文献
4.
The aim of this study was to validate the flow patterns measured by high-resolution, time-resolved, three-dimensional phase contrast MRI in a real-size intracranial aneurysm phantom. Retrospectively gated three-dimensional phase contrast MRI was performed in an intracranial aneurysm phantom at a resolution of 0.2 × 0.2 × 0.3 mm(3) in a solenoid rat coil. Both steady and pulsatile flows were applied. The phase contrast MRI measurements were compared with particle image velocimetry measurements and computational fluid dynamics simulations. A quantitative comparison was performed by calculating the differences between the magnitude of the velocity vectors and angles between the velocity vectors in corresponding voxels. Qualitative analysis of the results was executed by visual inspection and comparison of the flow patterns. The root-mean-square errors of the velocity magnitude in the comparison between phase contrast MRI and computational fluid dynamics were 5% and 4% of the maximum phase contrast MRI velocity, and the medians of the angle distribution between corresponding velocity vectors were 16° and 14° for the steady and pulsatile measurements, respectively. In the phase contrast MRI and particle image velocimetry comparison, the root-mean-square errors were 12% and 10% of the maximum phase contrast MRI velocity, and the medians of the angle distribution between corresponding velocity vectors were 19° and 15° for the steady and pulsatile measurements, respectively. Good agreement was found in the qualitative comparison of flow patterns between the phase contrast MRI measurements and both particle image velocimetry measurements and computational fluid dynamics simulations. High-resolution, time-resolved, three-dimensional phase contrast MRI can accurately measure complex flow patterns in an intracranial aneurysm phantom.  相似文献
5.
蛋氨酸合成酶基因多态性与颅内动脉瘤的关系   总被引:1,自引:1,他引:0  
目的探讨同型半胱氨酸和蛋氨酸合成酶(MS)A2756G基因多态性与颅内动脉瘤的关系。方法运用多聚酶链反应技术和化学发光法检测76例颅内动脉瘤及77例正常人MS A2756G基因多态性。结果颅内动脉瘤组的MSD919G DG基因型频率较正常对照高(P<0.01),患颅内动脉瘤的风险是对照组的6.35倍。两组等位基因频率差异无统计学意义(P>0 05)。结论 MS D9l9G的DG基因型与颅内动脉瘤明显相关,高同型半胱氨酸血症与颅内动脉瘤病发生有一定关系。  相似文献
6.
双源CT血管成像在Willis环区动脉瘤诊断及治疗中的应用   总被引:1,自引:1,他引:0  
目的:探讨双源CT血管成像(DSCTA)在Willis环区动脉瘤的诊断、分型及介入栓塞治疗中的临床应用价值.方法:术前采用DSCTA检查筛选颅内动脉瘤患者26例(33个).采用Seldinger技术,在DSA引导下行全脑血管造影,了解动脉瘤位置、形态、大小,测量瘤颈及瘤体直径;再根据不同的解剖学形态选用不同的介入栓塞方法治疗.结果:术前DSCAT和DSA检查对颅内动脉瘤的大小、位置、形状显示一致.26例患者共33个动脉瘤均成功栓塞,完全栓塞18个,占54.54%;栓塞程度在95%以上12个,占36.36%;不完全栓塞3个,占9.09%.结论:DSCTA检查和DSA全脑血管检查可提供颅内动脉瘤的位置、形态、大小等影像解剖学资料,为动脉瘤的临床分类和治疗方法的选择提供依据.  相似文献
7.
Meta-analysis of whole-genome linkage scans for intracranial aneurysm   总被引:1,自引:0,他引:1  
Genetic predisposition likely plays an important role in the development of intracranial aneurysms. We carried out a genome search meta-analysis to identified loci associated with intracranial aneurysm. We identified previous whole-genome linkage analyses by searching PUBMED. Five studies reported by separate investigators where detailed data could be obtained were included in our analysis. We synthesized the available genome-wide scan data by using a heterogeneity-based genome search meta-analyses. We identified two linkage sites on chromosomes 3 and 17 which had P-values <0.01 for association with intracranial aneurysm. Our findings confirm the association of a locus on chromosome 17 and identify a new linkage site on chromosome 3 for intracranial aneurysm. The new locus contains a number of potential gene candidates including kininogen-1 precursor, fibroblast growth factor-12 and endothelin converting enzyme 2.  相似文献
8.
Summary One of the gene loci (PKD1) responsible for autosomal dominant polycystic kidney disease was located in 1985 to the short arm of chromosome 16. The clinical consequences of this finding are analyzed. Genetic heterogeneity has been demonstrated since 5%–15% of the families inherit a non-PKD1 mutation. Progress in molecular genetics allows better classification of patients with some atypical manifestations, e.g., those with early renal failure or those with congenital hepatic fibrosis. Identification of the gene(s) and of their defects will provide further progress.Abbreviations ADPKD autosomal dominant polycystic kidney disease - ESRF end stage renal failure - PKD polycystic kidney disease - RFLP restriction fragment length polymorphisms  相似文献
9.
We report a patient who presented with headache due to diffuse subarachnoid hemorrhage. A four-vessel angiogram revealed a left posterior communicating artery aneurysm with fetal origin, persistent primitive trigeminal artery and hypoplastic vertebral artery on the same side. This association was considered coincidental and co-existence of a saccular aneurysm with an anatomical variation of intracranial vasculature is briefly discussed.  相似文献
10.
Endovascular stenting appears to be an appealing treatment modality to selected complex intracranial aneurysms. However, stents currently used for endovascular treatment are not specifically designed for the cerebrovasculature. Stent parameters, such as porosity and filament size, have to be carefully optimized for long-term successful treatment. We investigated the influence of the stent filament size on the intra-aneurysmal flow dynamics in a sidewall aneurysm model in vitro. Three helical stents with 76% porosity but different filament sizes of 178, 153, and 127 m were studied using particle image velocimetry. Twenty-four pulsatile flow conditions were investigated. The results show that stenting significantly reduces intra-aneurysmal vorticity and the mean circulation inside the aneurysm is reduced to less than 3% of its value before stenting. For constant porosity, a further reduction of the mean circulation, up to 30% can be obtained by reducing the filament diameter. For a constant Womersley number, this further reduction is accentuated with increase in the peak Reynolds number. Further reduction in the mean circulation inside the aneurysm was not achieved for the 127 m stent. With further reduction in filament diameter, the helical stent filaments positioned against the aneurysm neck started wavering with the flow transferring added momentum into the aneurysm. For stents of smaller filament diameter, a supporting ultrastructure is required. © 2002 Biomedical Engineering Society. PAC2002: 8719Uv, 8780Rb, 8719La, 0630Gv  相似文献
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