平板DSA新技术在介入治疗颈内动脉海绵窦瘘中应用初探  

Application of flat-panel digital subtraction angiography in interventional therapy for carotidcavernous fistulas： initial clinical experience

作　　者：石强[1] 梁传声[2] 臧培卓[2] 徐克[1] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001 [2]中国医科大学附属第一医院神经外科,沈阳110001

出　　处：《中华神经医学杂志》2009年第4期392-394,398,共4页Chinese Journal of Neuromedicine

基　　金：辽宁省教育厅基金项目（2008793）

摘　　要：目的探讨平板DSA新技术在介入治疗颈内动脉海绵窦瘘（CCF）中的应用价值。方法12例CCF患者术前行3D DSA检查，应用多平面重建技术定位瘘口并对瘘口进行测量。治疗中利用可调控实时透视路途技术（Landscap技术）制作路径图，以3D图像所示瘘口及周围骨性标志作为对照进行封堵治疗。结果12例CCF均可清晰定位瘘口，瘘口直径平均3．7mm。利用Landscap技术使颈内动脉路径及海绵窦骨性标志同时可见。球囊栓塞10例，弹簧圈栓塞1例，支架封堵瘘口1例。颈内动脉通畅11例，1例行颈内动脉闭塞。结论平板DSA 3D技术提供了瘘口的丰富信息，Landscap技术为治疗增加了骨性标志，其联合应用为治疗CCF提供了安全保障。Objective To assess the clinical value of flat-panel digital subtraction angiography （DSA） in interventional therapy for carotid-cavernous fistula （CCF）. Methods Three-dimensional （3D） DSA was performed in 12 patients with CCF before the interventional therapy. The fistular orifice was located and measured with multiplanar reconstruction technique, and the Landscap roadmap of the fistula was obtained. Fistula embolization was performed according to the location of the fistular orifice and the surrounding bony marker indicated by 3D and Landscap roadmap. Results The fistular orifices were clearly displayed in the 12 patients with an average orifice diameter of 3.7 mm. The internal carotid artery （ICA） and the bony marker of the cavernous sinus were shown simultaneously. Ten patients received endovascular embolization with detachable balloon, and 1 patient was treated with coil and 1 with stent placement. The ICA remained patent in 11 cases and carotid artery occlusion was performed in 1 case. Conclusion The 3D fiat-panel DSA provides rich information on the fistular orifice, and the bony markers can be identified by landscape roadmap technique. The combination of these two techniques guarantees effective and safe treatment of CCF.

关 键 词：颈内动脉海绵窦瘘 栓塞 治疗性 介入放射学 

分 类 号：R686[医药卫生—骨科学]