Willis环周围窄颈动脉瘤形态学特点与介入栓塞治疗的临床意义

目的:探讨Willis环周围窄颈动脉瘤的检查方法、形态学特点及介入治疗的疗效.方法:术前采用双源CT血管成像(DSCTA)检查筛选Willis环周围窄颈动脉瘤患者31例,采用Seldinger技术,行3D DSA全脑血管造影,根据动脉瘤的不同解剖学形态选用合适的弹簧圈进行介入栓塞治疗.结果:31例患者共36枚动脉瘤,均栓塞成功,完全栓塞28枚(77.78%),大部分栓塞8枚(22.22%).随访6～12个月,所有患者均未发生再出血或脑血栓形成.结论:术前根据DSCTA检查资料和DSA图像对Willis环周围窄颈动脉瘤的形态进行分析,能为动脉瘤的诊断和治疗提供依据;根据不同的形态学特点选用合适的弹簧圈进行栓塞,是一种安全有效的介入治疗方法.

Morphologic Features of Narrow-necked Aneurysms in Willis Circle and Clinic Significance of Interventional Embolotherapy

Objective： To investigate the examination methods, morphologie features and curative effects of interventional therapy for the narrow - necked aneurysms in Willis circle. Methods ： Dual source computed tomography angiography （DSCTA） was performed in screening patients before interventional therapy, then aortocranial angiography under the guidance of DSA was used through Seldinger technology. According to their different anatomic features, these aneurysms were treated through interventional embolotherapy with proper coils. Results ：36 aneurysms were all successfully treated by embolism in 31 patients. Complete embolism was achieved in 28 aneurysms （77.78%） and partial embolism was achieved in 8 aneurysms （22.22%）. During a follow - up period of 6 to 12 months, no rehaemorrhagia and cerebral thrombosis occurred. Conclusions ： To analyze morphologic features of narrow - necked aneurysms according to image of DSCTA and DSA before interventional measure can provide evidence for the diagnosis and therapy, and apply for proper coils to carry out embolotherapy on basis of different morphologic features , which is a safe and effective interventional therapy.