吲哚菁绿荧光强度分析在颅内动脉瘤术中的应用

目的 探讨吲哚菁绿血管造影及荧光强度分析在颅内动脉瘤夹闭术中的作用.方法回顾性分析吲哚菁绿血管造影及荧光强度分析在47例颅内动脉瘤患者夹闭术中的作用.术中行吲哚菁绿荧光血管造影,观察动脉瘤、载瘤动脉及分支血管的血流情况,并通过荧光强度分析软件进行分析.结果47例中有4例通过吲哚菁绿血管造影检测到动脉瘤夹闭不全,术中荧光强度分析为3例动脉瘤的夹闭提供了重要信息.结论 吲哚菁绿血管造影能在术中对术野血流情况进行实时的分析,而通过荧光强度分析可进一步提高吲哚菁绿血管造影对血流分析的准确性.

Application of intraoperative near-infrared indocyanine green videoangiography and analysis of fluorescent intensity in cerebral aneurysm surgery

Objective To study the application of intraoperative near - infrared indocyanine green videoangiography and visual analysis of blood flow dynamics in cerebral aneurysm clipping surgery,and analyze the advantages and limitations.Methods 47 patients with 51 intracranial aneurysms were treated by microsurgical clipping.Intraoperative ICG videoangiography was performed before or/and after clip application.The infrared fluorescence module integrated into the surgical microscope was used to visualize fluorescent areas in surgical field and permitted the recording of a video of the emitted fluorescent light.The recorded video signal was then constantly analyzed by an integrated analytical visualization tool for rapid interpretation of the fluorescence video sequences with intensity diagram.Results All of the images provided high resolution allowing real time assessment of the blood flow of parent artery,arterial branches or small perforators.Incomplete clipping of 4 anearysms were detected by using ICG angiography.Perforating arteries arising closed to or from aneurysmal neck were identified in the surgical eid of 15 aneurysms and the ICG angiography allowed real time assessment of the blood flow.The intensity diagram of ICG angiography provided important imformation in three cases.Conclusions ICG video angiography could provide high resolution images allowing real time assessment of the blood flow of parent artery,arterial branches or small perforators to improve the outcome of intracranial aneurysm surgery.The intensity diagram function is useful as an adjunct to ICG video angiography for documenting the blood flow.