三维数字减影血管造影在颅内动脉瘤诊疗中的应用价值

目的：探讨3D—DSA在颅内动脉瘤诊断和治疗中的应用价值。方法：对蛛网膜下腔出血患者常规行DSA检查，发现病变或可疑病变后行3D—DSA检查。结果：26例颅内动脉瘤中检出动脉瘤31枚，其中后交通9枚，C1段3枚，C2段5枚，C3段3枚，前交通6枚，大脑中3枚。椎动脉动2枚。3例2D—DSA未见病变3D—DSA确诊，5例因血管重叠3D—DSA排除了动脉瘤。6枚GDC栓塞，5枚手术夹闭，2枚颈内动脉可脱性球囊封阻术。结论：3D—DSA极大提高了脑血管造影检查的准确性和可靠性，为动脉瘤的介入治疗和手术夹闭提供了可靠保障，在临床诊疗中具有很高的应用价值。

Three-dimensional digital subtraction angiography for diagnosis and treatment of intracranial aneurysms

Objective:To investigate the application value of three-dimensional digital subtraction angiography(3D-DSA) in the diagnosis and treatment of intracranial aneurysms.Methods: The patients with subarachnoid hemorrhage were routinely examined by DSA.Those with positive changes were further examined by 3D-DSA.Results: Thirty-one lesions of intracranial aneurysms were found in 26 patients by 3D-DSA.Nine aneurysms were located at posterior communicating arteries and 6 aneurysms at anterior communicating arteries.Three aneurysms were located in C_1,5 in C_2,and 3 in C_3 segments.Two aneurysms were located at vertebral artery.Three aneurysms not discovered by 2D-DSA were finally diagnosed by 3D-DSA.Five suspected lesions during conventional DSA were ruled out by 3D-DSA because of overlapping blood vessels.Six aneurysms were treated by embolism with Guglielmi detachable coil(GDC) and 4 were occluded by surgery.The detachable balloon was used in one case.Conclusion: 3D-DSA is valuable in the diagnosis and treatment of intracranial aneurysms.It improves the precision and reliability of brain angiography greatly and provides strong support for interventional and surgical therapy.