旋转DSA及三维重建技术在颅内动脉瘤介入治疗中的价值

目的 :分析旋转DSA及三维重建技术对颅内动脉瘤栓塞治疗和手术治疗的价值。方法 :10 0例蛛网膜下腔出血的患者除进行常规全脑血管造影外 ,对颅内的双侧椎动脉、颈内动脉进行旋转DSA图像采集及三维重建 ;对 82例经旋转DSA及三维重建证实为颅内动脉瘤的病例进行介入栓塞治疗或手术夹闭治疗 ,术后行旋转DSA检查及图像的三维重建 ,评价介入栓塞治疗或手术夹闭治疗的效果。结果 :10 0例蛛网膜下腔出血患者中 ,全脑血管造影检出动脉瘤 76例 ;经旋转DSA采集及图像三维重建后 ,检出动脉瘤 82例。其中 71例行GDC或EDC介入栓塞治疗 ,11例行手术夹闭治疗。术后经旋转DSA及三维重建证实 ,71例介入栓塞的病例中 ,67例全部栓塞 ,4例 90 %栓塞。 11例手术夹闭病例均完全夹闭。结论 :旋转DSA及三维重建技术可以明显提高颅内动脉瘤的检出率 ;能够多角度立体观察、直观清晰地显示动脉瘤的大小、形态、瘤颈的宽度及与载瘤动脉的关系 ;为介入栓塞治疗或手术夹闭治疗提供精确的数据 ;评价动脉瘤介入栓塞治疗或手术夹闭治疗的效果。

Clinical value of rotating DSA and 3D-reconstruction in the interventional treatment of intracranial aneurysm

Objective:To evaluate the technique of rotating DSA and 3D-reconstruction in the interventional examination and embolization or surgical treatment of intracranial aneurysms.Methods:100 cases diagnosed as subarachnoid hemorrhage were examined routinely.It included four-vessl angiogram and rotating DSA and 3D-reconstruction of bilateral VA and bilateral ICA.82 cases were diagnosed as intracranial aneurysm by rotation DSA and 3D-recontruction,and referred to internventional embolization or surgical clipping therapy.Rotating DSA and 3D-reconstruction images were obtained after therapy and the effects of interventional embolization or clipping surgery were evaluated.Results:In 100 cases of subarachnoid hemorrhage,76 cases were diagnosed as intracranial aneurysm by routine four-vessel angiogram and 82 cases were diagnosed after rotating DSA and 3D-reconstruction.In 82 positive cases,71 were performed GDC or EDC embolization,11 cases underwent clippping surgery.Using rotating DSA and 3D-reconstruction after treatment,the embolization was found to be 100% in 67 cases and 90% in 4 cses,and the occlusion with surgical clipping was found to be complete.Conclusion:Rotating DSA and 3D-reconstruction technique can increase the diagnostic accuracy of intracranial aneurysm.The size,form,neck width and relationship with neibouring vessel can be clearly demonstrated.It can provide precise data and can also evaluate the outcome for the interventional or clipping treatment.