吲哚菁绿血管造影在脑血管畸形手术中的作用  

Effect of intraoperative indocyanine green angiography on surgery for cerebral vascular malformations

作　　者：马驰原[1] 史继新[1] 王汉东[1] 杭春华[1] 谢伟[1] 孙康健[1] 吴伟[1] 

机构地区：[1]南京军区南京总医院神经外科,210002

出　　处：《中国脑血管病杂志》2008年第8期369-371,378,共4页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨吲哚菁绿(ICG)血管造影在脑血管畸形手术中的作用。方法回顾性分析2007年6月至2008年5月,南京军区南京总医院神经外科手术治疗的5例脑血管畸形患者。术中应用ICG显示畸形血管、供血动脉和引流静脉,评价术中ICG造影在手术中的作用。结果本组5例脑血管畸形患者,其中脑动静脉畸形2例,硬脑膜动静脉瘘3例。5例患者均接受了脑血管畸形切除术。2例脑动静脉畸形手术中在切除畸形团前进行了术中ICG血管造影,清晰显示出畸形团、供血动脉和引流静脉;3例硬脑膜动静脉瘘手术中应用ICG造影确定了瘘口的位置,成功地阻断瘘口。患者术后复查DSA,证实畸形血管均被完全切除,正常血管得到保留。结论术中ICG血管造影能够帮助术者明确脑血管畸形的状况,指导手术治疗脑血管畸形。研究支持在脑血管畸形手术中常规应用ICG脑血管造影。Objective To investigate the effect of intraoperative indocyanine green （ICG） angiography on surgery for cerebral vascular malformations. Methods Five patients with cerebral vascular malformation were operated from 2007 to 2008, and the ICG was used for revealing the nidus, the feeding arteries and the draining veins during the operation. The effect of intraoperative ICG angiography was evaluated. Results There were five patients with vascular malformation in this group, two of them had cerebral arteriovenous malformation and 3 had dural arteriovenous fistula. All of the 5 patients received radical resection of their lesions. Two patients with cerebral arteriovenous malformation performed intraoperative ICG angiography before resection of the nidus. The angiography clearly revealed the malformation nidus, the feeding arteries and the draining veins. Three patients with dural arteriovenous fistula performed ICG angiography to determine the location of the fistulae and obliterated it successfully. Postoperative DSA demonstrated that the malformed vessels were resected completely and the normal vessels were preserved. Conclusion Intraoperative ICG angiography may help the surgeons to identify and to guide the surgical management of cerebral vascular malformation.

关 键 词：中枢神经系统血管畸形 吲哚菁绿 血管造影术 数字减影 

分 类 号：R651.1[医药卫生—外科学]