三维数字减影血管造影在颅内动脉瘤诊断和治疗中的作用

目的探讨三维数字减影血管造影(3D-DSA)在颅内动脉瘤的诊断及制定治疗策略中的价值。方法选择急性蛛网膜下腔出血并疑似颅内动脉瘤的患者53例,在常规数字减影血管造影(2D-DSA)的基础上行3D-DSA检查,根据造影结果制定相关治疗策略。结果53例患者中经3D-DSA证实共检出45例57个动脉瘤,3D-DSA较2D-DSA能更好地显示动脉瘤立体形态、载瘤动脉与毗邻血管的关系、瘤颈及其与载瘤血管关系,准确判断动脉瘤血管内治疗和外科手术夹闭的可行性,并为栓塞或支架置入提供最佳工作角度。结论3D-DSA可提高颅内动脉瘤特别是<2mm动脉瘤的检出率,为制定颅内动脉瘤的治疗策略提供准确、有效的信息,从而进一步提高动脉瘤血管内治疗和手术的安全性。

Role of three-dimensional digital subtraction angiography in diagnosis and treatment of intracranial aneurysms

Objective To evaluate the role of three-dimensional digital subtraction angiography(3D-DSA)in diagnosis and treatment of intracranial aneurysms.Methods 3D-DSA was performed in 53 cases with subarachnoid hemorrhage or suspected aneurysms on the basis of general digital subtraction angiography(2D-DSA)and then the strategy of treatment was constituted accordingly.Results Fifty-seven aneurysms in 45 patients were identified with 3-DSA.Compared with 2D-DSA,3D-DSA could more clearly present the stereo-shape,relationship between aneurysmal artery and adjacent vessels,neck of the aneurysm and its relation with the parent artery,which helped to correctly judge the feasibility of endovascular or surgical treatment and provide the best angle of embolization or stenting.Conclusions 3D-DSA can raise the detection rate of aneurysm,especially for those with diameter less than 2 mm,and can offer accurate and effective information for surgeons to formulate therapeutic strategy,which can improve the security of endovascular or surgical treatment.