颅内动脉瘤的数字减影血管造影诊断及介入治疗

目的：总结数字减影血管造影(DSA)在颅内动脉瘤诊断中的价值及电解式可脱弹簧圈栓塞颅动脉瘤的疗效。方法：对60例蛛网膜下腔出血病例行全脑血管数字减影血管造影(DSA)检查,总结颅内动脉瘤的数字减影血管造影表现;对适合进行血管内治疗的8例进行了电解式可脱弹簧圈栓塞治疗。结果：60例中,发现颅内动脉瘤26例、共33个,其中单发病例2l例,多发病例5例;后交通动脉瘤12例,颈内动脉瘤11例,前交通动脉瘤7例,大脑中动脉瘤3例;动脉瘤呈囊状16例,梭形5例,球形4例,葫芦形4例,其他不规则形4例;动脉瘤直径在2～21mm之间;8例伴脑血管痉挛,7例动脉瘤内有血栓形成。8例GDC栓塞病例中,动脉瘤腔100％栓塞5例,95％栓塞2例,80～90％栓塞l例。弹簧圈少量脱出动脉瘤l例次,过度栓塞l例次。结论：数字减影血管造影(DSA)是确诊颅内动脉瘤不可缺少的检查方法;电解式可脱弹簧圈栓塞是一种治疗颅内动脉瘤有效的新方法。

Digital Substraction Angiography Diagnosis and Interventional Therapy of Intracranial Aneurysm

Objective:To sum up the application of digital subtraction angiography diagnosis of intracranial aneurysm and the experience of embolization of intracranial aneurysm with Guglielmi detachable coil(GDC).Methods:Sixty case were examined with digital subtraction angiography and the signs of intracranial aneurysm were summarized,and 8 case was embolized with GDC.Result:Among the 60 case,there were 33 aneurysms in 26 case,among the 33 aneurysm there were 21 cases mono-episode and 5 cases multi-episode;12 aneurysms involved the posterior communicating artery,11 the internal carotid artery,7 the anterior communicating artery,3 the middle cerebral artery;16 bladder shape,5 fusiform in shape,4 was calabash shap el,globular shap el and other 4 aneurysms shapeless;the diameter of the aneurysms between 2-21mm;8 cases was accompanied with cerebral vessels spasm,7 cases thrombosis.Among the 8 intracranial aneurysms embolized with GDC,in 5 case the cevity of aneurysms were 100 percent enbolized,2 cases were embolized 95-99%,1 case were embolized 80-90%;1 case the coil end protruding and 1 case over-embolized.Conclusion:The digital substraction angiography was a indispensable examination in making there final diagnosis intracranial aneurysm ,and it was a new therapeutic method with embolization of intracranial aneurysm with guglielmi detachable coil.