三维数字减影血管造影在脑动静脉畸形血管内治疗中的应用

目的探讨三维数字减影血管造影(3D-DSA)在脑动静脉畸形(AVM)血管内治疗中的临床应用价值。方法选择22例脑AVM患者进行血管内治疗,在治疗过程中均行3D-DSA,分析AVM供血动脉、引流静脉的特征和畸形血管团的内部结构,并与二维DSA比较。结果二维DSA和3D-DSA均可正确诊断脑AVM,但对AVM供血动脉、引流静脉及AVM内部结构的显示3D-DSA优于二维DSA。本组22例脑AVM中,二维DSA清晰显示供血动脉13例(59.1%),而3D-DSA清晰显示20例(90.9%);二维DSA和3D-DSA清晰显示引流静脉分别为15例(68.2%)和20例(90.9%),清晰显示AVM内部结构分别为5例(22.7%)和17例(77.3%)。同时对合并的动脉瘤,二维DSA仅清晰显示1例,而3D-DSA则清晰显示了6例。结论 3D-DSA在脑AVM血管内治疗中具有重要的应用价值。

Application of three dimensional digital substraction angiography to endovascular treatment of cerebral arteriovenous malformation

Objective To explore the applied value of three dimensional digital subtraction angiography（3D-DSA） to endovascular treatment of cerebral arteriovenous malformation（CAVMs） . Methods Twenty-two patients with CAVMs were treated by endovascular treatment,during which 3D-DSA was performed in all the patients. The characteristics of the arteries supplying blood for CAVMs and draining veins and internal structures of the CAVMs were analyzed by 3D-DSA. Results CAVMs were definitely diagnosed as by two-dimensional DSA（2D-DSA） and 3D-DSA in 22 patients. The arteries supplying blood for CAVMs were clearly shown by 2D-DSA in 13 patients and by 3D-DSA in 20 patients. The veins draining CAVMs were clearly shown by 2D-DSA in 15 patients and by 3D-DSA in 20 patients. The internal structures of CAVMs were clearly shown by 2D-DSA in 5 patients and by 3D-DSA in 17 patients. The aneurysm accompanied with CAVM was clearly shown by 2D-DSA in 1 patient and ones by 3D-DSA in 6 patients. Conclusions The 3D-DSA has great value to endovascular treatment of CAVMs and it can provide more valuable information compared to 2D-DSA in the patients with CAVMs.