三维数字减影血管造影在脑血管病诊断和介入治疗中的价值

目的 探讨三维数字减影血管造影（3D－DSA）在脑血管疾病中的诊断和血管嫩治疗的价值。方法 40例疑有脑血管病的患者均在3D－DSA系统的操作床上行普通DSA,然后行三维重建成像处理作出正确的诊断,再根据3D－DSA处理图片数据拟定介入治疗方案。结果 40例疑有脑血管病的患者均行普通DSA检查,阳性率为85.0%,3D－DSA处理后阳性率为95.0%。共确诊38例,其中脑动脉瘤15例,GDC栓塞治疗13例,100％栓塞11例,90％以上栓塞2例。脑动静脉畸形9例,100％栓塞7例,90％以上栓塞2例。缺血性中风14例,其中血管狭窄9例,支架置入8例,7例狭窄血管100％开通;血管闭塞5例,尿激酶动脉内溶栓治疗,完全再通2例,部分再通2例,不通1例。并发症3例（7．9％）。结论 3D－DSA能够提高脑血管病的检出率,明显优于普通DSA,对评价脑血管病的血管内治疗有潜在的价值。

Value of three-dimensional digital subtraction angiography in diagnosis and planning endovascular treatment of cerebrovascular diseases

OBJECTIVE: To evaluate the value of three-dimensional (3D) digital subtraction angiography (DSA) in diagnosis and planning endovascular treatment of cerebrovascular diseases. METHODS: Standard DSA and 3D-DSA were performed in 40 adult patients (aged 21 approximately 74 years) suspected to be with cerebrovascular diseases. The schemes of endovascular treatment were worked out according to the results of 3D-DSA. RESULTS: Positive rate of standard DSA and 3D-DSA were 85.0% and 95.0% respectively in diagnosis of cerebrovascular diseases. 100% occlusion was achieved in 11 patients with intracranial aneurysms and in 7 patients with arteriovenous malformations, and 100% recanalization was achieved in 9 patients with ischemic stroke. Temporary complications were found in 3 of all patients (7.9%). CONCLUSIONS: 3D-DSA is an ideal tool superior to standard DSA in diagnosis of cerebrovascular diseases and has potential value for evaluating endovascular treatment of cerebrovascular diseases.