颅内动脉瘤栓塞术后的DCE-MRA随访  

Clinical Application of Dynamic Contrast-enhanced MR Angiography in the Follow-up of Intracranial Aneurysms after Endovascular Treatment

作　　者：徐钐[1] 陆建平[2] 刘琦[2] 王莉[2] 金爱国[2] 

机构地区：[1]中国人民解放军第187医院放射科,海口571159 [2]第二军医大学附属长海医院影像科,上海200433

出　　处：《放射学实践》2010年第2期136-139,共4页Radiologic Practice

摘　　要：目的:评价DCE-MRA在颅内动脉瘤栓塞术后随访中的应用价值。方法:回顾分析了56例颅内动脉瘤患者血管内栓塞治疗后的DCE-MRA和DSA随访图像,以DSA为诊断标准,比较两者的随访结果,评价DCE-MRA随访的准确性。DCE-MRA的原始图像减影后行VR、MIP重建,并结合原始图像。结果:56例患者共61个动脉瘤进行了栓塞治疗,随访中发现40个动脉瘤完全栓塞,12个瘤颈残留,9个瘤体复发,动脉瘤的复发率为14.75%。DCE-MRA与DSA随访结果有良好的一致性(κ=0.871,P<0.005),DCE-MRA随访的准确率达到93.4%,假阳性和假阴性各2例。结论:DCE-MRA是颅内动脉瘤栓塞术后的一种无创、可靠、快速的影像随访方法,有助于监测术后瘤颈残留和瘤体复发,指导临床进一步治疗。Objective：To explore the clinical value of dynamic contrast-enhanced MR angiography in the follow-up of intracranial aneurysms after endovascular treatment. Methods： 56 patients harboring 64 intracranial aneurysms who had received endovascular treatment were included in this retrospective study. Three aneurysms were too small to treat. All patients underwent both dynamic contrast-enhanced MR angiography （DCE-MRA） and digital subtraction angiography （DSA） after endovascular therapy. The interval between DCE-MRA and DSA was less than 2 weeks. The goal was to evaluate DCE-MRA contrasting to DSA for the detection of residual aneurysm neck or aneurysm recurrence. DCE-MRA analysis was based on MIP,VR and sourse images. DSA was considered as the gold Standard for diagnosis. Results： In the 61 aneurysms,DSA revealed complete occlusion in 40 cases, residual aneurysm neck in 12 cases,and aneurysm recurrence in 9 cases. DCE-MRA and DSA showed a good and significant agreement between techniques （k=0. 871 ,P〈0. 005）. The sensitivity of DCE-MRA was 93.4%. There were two false-positive and false-negative cases each. Conclusion：DCE-MRA is a noninvasive,valuable and fast method for the follow-up of intracranial aneurysms after endovascular therapy. It is useful in the monitoring of residual aneurysm neck or aneurysm recurrence after endovascular treatement.

关 键 词：颅内动脉瘤 栓塞术 磁共振成像 

分 类 号：R732.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]