颅内动脉瘤夹闭术后残留动脉瘤的3D-DSA评估

目的 评估3D-DSA在颅内动脉瘤夹闭术后检测残留动脉瘤中的利用价值.方法 对29例已实施动脉瘤夹闭术的颅内动脉瘤(35个动脉瘤)患者,在术后3-6个月内行3D-DSA及DSA检查,评估3D-DSA对残留动脉瘤的检出效果并与DSA结果进行比较.结果 3D-DSA检出残留动脉瘤共10个,其中8个瘤颈残留动脉瘤为术中已经确认瘤颈残留的动脉瘤,其他2个瘤体残留动脉瘤为术中不能确认是否完全夹闭的动脉瘤.而DSA共检出残留动脉瘤3个.其中1个瘤颈残留动脉瘤及2个瘤体残留动脉瘤与3D-DSA结果符合,而其他残留动脉瘤均表现为假阴性结果.结论 3D-DSA对动脉瘤夹闭术后残留动脉瘤的检出效果明显优于DSA,尤其对较小瘤颈残留动脉瘤具有较高的敏感度和准确性,故有助于术后长期随访观察残留动脉瘤的形态变化.

Evaluation for residual aneurysms by three- dimensional digital subtraction angiography after intracranial aneurysm clipping

Objective The aim of this study was to assess the values of detecting intracranial residual aneurysms by three - dimensional digital subtraction angiography (3D - DSA) after clipping. Methods 3D - DSA and DSA were performed on 29 patients (35 aneurysms) after 3 to 6 months of clipping to assess the effect of detecting residual aneurysms by 3D - DSA contrasting to DSA. Results 10 residual aneurysms were detected by 3D - DSA, in which 8 neck residual aneurysms had been confirmed as the neck residual aneurysms, the other 2 residual dome aneurysms could not be confirmed as the completely clipped aneurysms in operations; However, only 3 aneurysms were detected by DSA, in which 1 neck residual aneurysm and 2 residual dome aneurysms were in line with the results of3D -DSA. While the other 7 residual aneurysm, which were detected by 3D - DSA, appeared as false negative results. Conclusion The effect of detecting residual aneurysms after clipping by 3D - DSA was obviously better than by DSA. 3D -DSA was more sensitive and accurate, especially in detecting the less neck remnant aneurysms. 3D - DSA was good at observing the morphologic change of residual aneurysms in long - term follow - up after clipping.