CTA模拟入路早期手术治疗破裂动脉瘤  

CT angiography-based simulation of the surgical approach in early operation for ruptured aneurysm

作　　者：王知非[1] 廖达光[1] 张天一[1] 杨金福[1] 刘飞[1] 

机构地区：[1]中南大学湘雅三医院神经外科,湖南长沙410013

出　　处：《南方医科大学学报》2009年第12期2492-2494,2496,共4页Journal of Southern Medical University

摘　　要：目的应用三维CT血管造影(3D-CTA)模拟入路,探讨在颅内动脉瘤破裂后,早期手术治疗中3D-CTA的应用价值。方法选择经早期手术证实的颅内动脉瘤破裂致蛛网膜下腔出血患者48例,Hunt-Hess分级:Ⅰ级11例,Ⅱ级29例,Ⅲ级8例,术前均行3D-CTA检查并进行动脉瘤手术模拟,将患者的术前CTA与术中所见进行比较,分析3D-CTA的临床应用价值。结果术前3D-CTA能清晰地显示动脉瘤位置、大小、形态、瘤顶指向、瘤颈宽窄、载瘤动脉、动脉瘤与周围血管及骨结构关系,且与术中所见基本一致;出院时GOS预后评分:5分41例、4分4例、3分2例、2分1例。结论3D-CTA可对颅内动脉瘤开颅夹闭术进行模拟,从而提高手术的成功率。Objective To simulate the surgical approaches for intracranial aneurysms using three-dimensional CT angiography （3D-CTA） and assess the value of 3D-CTA in early microneurosurgery for ruptured intracranial aneurysms. Methods Forty-eight patients with spontaneous subarachnoid hemorrhage due to ruptured intracranial aneurysm were confirmed by early operation. All the patients were classified according to Hunt-Hess, including 11 of grade Ⅰ, 29 of gradeⅡ, and 8 of gradeⅢ. CTA was performed before the operation and surgical simulation was conducted. The preoperative findings on CTA and the intraoperative findings were compared and the clinical value of cerebral 3D-CTA was analyzed. Results Pre-operative 3D-CTA clearly displayed the location, size and shape of the aneurysms, the axis direction of the aneurysm apex and the width of aneurysm neck. The spatial relation between the parent aneutysm artery, the aneurysm, the peripheral vessels and the bony structures were also demonstrated. These findings were basically consistent with the intraoperative findings. The Glasgow outcome score was 5 in 41 patients, 4 in 4 patients, 3 in 2 patients, and 2 in 1 patient upon discharge from the hospital. Conclusion Preoperative 3D-CTA examination can simulate the surgery for ruptured aneurysms to help improve the surgical success rate.

关 键 词：三维CT血管造影术 颅内动脉瘤 模拟手术 

分 类 号：R651.12[医药卫生—外科学]