3D-DA对颅内动脉瘤的诊断及术前价值的评估

目的探讨三维数字血管造影(3D-DA)在颅内动脉瘤诊断和术前评估中的作用和意义。方法回顾性分析我院2008年11月以来57例疑似颅内动脉瘤患者的3D-DA及常规DSA影像资料,分别由两位放射科医师和两位神经外科医生综合分析评定,以DSA和/或外科手术术中所见为标准,评判3D-DA对颅内动脉瘤的诊断价值及术前评估作用。结果 57例患者经过外科手术和/或DSA证实3D-DA对复杂和微小的多发动脉瘤细节显示上更具优势,能清晰显示动脉瘤的瘤体大小和指向、瘤颈、载瘤动脉及动脉瘤与邻近血管和骨性结构间的解剖关系。结论 3D-DA能清楚显示颅内动脉瘤的形态特征和邻近解剖关系,使颅内动脉瘤治疗方案的制订更加科学,是常规DSA有力的补充,两者有机结合应用可提高动脉瘤的诊治水平。

Evaluation of imaging diagnosis and assessment value of three-dimensional digital angiography for intracranial aneurysms

Objective To investigate the performance of three-dimensional digital angiography(3D-DA) for the detection and the preoperative assessment of intracranial aneurysms.Methods 57 consecutive patients suspected of intracranial aneurysms were recruited.All patients underwent both DSA and 3D-DA for the detection of intracranial aneurysms.All of the imaging were reviewed by two radiologists and two neurosurgeons.The Sensitivity,specificity,and positive and negative predictive values for aneurysm detection with 3D-DA by using DSA and surgical findings as the reference standard.Results Among the 57 suspected patients.3D-DA should could clearly show the shape,the size,the neck,the axis pointing and the parent artery of the aneurysms,as well as the relationship with the surrounding skull structures.3D-DA should be excellent performed in cases of multiple intracranial aneurysms with complex shapes or very small size.Conclusion 3D-DA is a surpassingly accurate and comprehensive imaging method for the shape features and the adjacent relationship of aneurysms.It can be used as an important supplement to DSA in the treatment and the preoperative assessment of intracranial aneurysm.