旋转DSA及三维重建在颅内动脉瘤诊断中的价值

目的探讨三维旋转DSA对颅内动脉瘤的诊断价值。方法使用荷兰PHILIPS公司数字减影机．对20例疑有动脉瘤的蛛网膜下腔出血患者作旋转DSA检查．并行三维重建，再与常规DSA检查比较．得到关于动脉瘤的定位、动脉瘤清晰度、瘤颈及血管分支的解剖图像。结果常规DSA检查发现16例16个动脉瘤．其中3例3个动脉瘤的方向和载瘤动脉及周围血管解剖关系显示不清，1例1个动脉瘤的颈部显示不清；4例阴性。加摄旋转DSA检查并行三维重建后，明确诊断颅内动脉瘤的18例18个．2例未见动脉瘤；且动脉瘤的全貌．瘤颈的位置与结构及周围血管分支的解剖关系显示清晰．避免了因血管重叠而产生的对动脉瘤的遮挡。结论旋转DSA可更好、更清晰的连续显示动脉瘤的颈部及周围的血管解剖结构，加三维重建后动脉瘤的大小、方向、与载瘤动脉周围血管的关系成立体解剖结构．即提高了动脉瘤的血管造影诊断准确性．又为手术和介入治疗提供更为准确的参考价值。

Role of rotational DSA with three-dimensional reconstruction in the diagnosis of intracranial aneurysms

Objective To assess the role of rotational DSA with three-dimensional (3-D) reconstruction in the diagnosis of intracranial aneurysms by comparing DSA with rotational DSA. Methods Conventional anteroposterior lateral and oblique views of DSA and rotational DSA were respectively performed in 20 patients suspected of intracranial aneurysms with subarachnoid hemorrhage by using DSA (Philips ALLUR12 system). Images were compared for the localization of aneurysms, the shape of aneurysm necks and the vascular branch anatomy. Results Among the 20 patients, 16 intracranial aneurysms in 16 patients were found by conventional DSA and the other 4 patients were negative; 3 aneurysms in 3 patients showed in conventional DSA unclear parent arteries and the adjacent vessels and 1 had a vague view of aneurysm neck. Rotational DSA with 3-D reconstruction revealed 18 aneurysms in 18 patients. Comparing to conventional DSA, rotational DSA with 3-D reconstruction could not only clarify the relationships of aneurysms with their parent arteries and the around vascular branches, but find the aneurysms which may be not able to be showed with conventional DSA. Conclusion Compared with conventional DSA, rotational DSA can get better visibility of vascular anatomy and aneurysm neck, and 3-D reconstruction can offer more important information for operation and interventional therapy.