2D—DSA与R—DSA及3D—DSA在脑动脉瘤诊疗中的应用  

Comparision of 2D -DSA ,R- DSA ,3D -DSA in diagnosis and treatment of intracranial aneurysms

作　　者：董富山[1] 翟水亭[1] 王子亮[1] 李天晓[1] 

机构地区：[1]河南省人民医院,郑州450003

出　　处：《中原医刊》2008年第6期3-5,共3页Central Plains Medical Journal

摘　　要：目的 通过对比2D—DSA、R—DSA与3D—DSA在显示脑动脉瘤瘤体的大小、瘤颈的宽窄及与毗邻血管的关系，说明3D—DSA优于2D—DSA及R—DSA。方法42例资料完整的颅内动脉瘤患者均行2D—DSA、R—DSA及3D—DSA检查，常规2D—DSA检查后即行R—DSA检查，把R—DSA图像传送到3D工作站，由3D工作站生成容积再现图像（VR）。通过图像在对脑动脉瘤瘤体的大小、形态、瘤颈的宽窄与毗邻血管的关系等方面显示评价分析。对50个行血管内栓塞治疗动脉瘤的数据进行统计学处理。结果①动脉瘤的显示：2D—DSA未能发现3个动脉瘤，这些动脉瘤在R—DSA上为不确定。VR可以发现所有的动脉瘤。②图像的整体质量：2D—DSA可以清楚显示细小动脉，图像整体质量优于R—DSA和3D—DSA。（④动脉瘤形状的显示：VR明显优于2D—DSA和R—DSA。动脉瘤瘤颈和动脉瘤与毗邻血管的关系的显示：VR明显优于2D—DSA和R—DSA。结论3D—DSA在颅内动脉瘤诊疗方面优于2D—DSA和R—DSA。尤其是对动脉瘤颈宽窄的显示，对介入手术治疗有着重要的意义。Objective To evaluate the advantages of 3D-DSA as compared to 2D-DSA, R-DSA in detecting the saccular size and neck size of the aneurysm and its relationship with parent vessels. Methods Forty- two patients with cerebral aneurysms underwent 3D-DSA,2D-DSA and R-DSA. After standard 2D-DSA,rotational DSA was performed, then R-DSA images were transitted to the 3D-workstation. The volume-rendering images were created from the rotational-DSA data sets by the workstation. All images were assessed for overall image quality, presence of aneurysm, visualization of aneurysmal neck, and relationship to adjacent vessels. Statistical analysis was conducted for 50 aneurysms by endovascular treatment. Results 1. The presence of aneurysm：Three aneurysms that were not detected at 2D-DSA were classified as uncertain on the basis of rotational-DSA. All aneurysms were classified as definitive presence on the basis of volume-rendering findings. 2. Overall image quality of rotational-DSA and 3D-DSA was statistically inferior to that of the standard 2D-DSA for visualization of distal arteries. 3. For detection of aneurysmal shape, visualization of aneurysmal neck and its relationship to neighboring arteries, volume-rendering images were significantly superior to 2D-DSA and R-DSA. Conclusion 3D-DSA is superior to the standard 2D-DSA and R-DSA in diagnosis of intracranial aneurysm, particularly visualization of aneurysmal neck, and this is very important for endovascular treatment of intracranial aneurysm.

关 键 词：脑动脉瘤 2D—DSA R—DSA 3D—DSA 

分 类 号：R739.41[医药卫生—肿瘤] R-05[医药卫生—临床医学]