三维重建结合手术体位改变在脑动脉瘤介入治疗中的应用价值  

Evaluation of 3D-reconstruction technique combined with the adjusting of patient's head position in performing the interventional procedure for intracranial aneurysms

作　　者：赵亮[1] 王嵇[1] 许建荣[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,200127

出　　处：《介入放射学杂志》2011年第11期909-912,共4页Journal of Interventional Radiology

基　　金：上海市重点学科建设项目资助(S03203);上海交通大学医学院重点学科资助

摘　　要：目的评价旋转三维重建技术及术中体位在脑动脉瘤介入治疗中的应用价值。方法采用GE INNOVA 3100数字减影血管造影系统对25例患者进行脑动脉正侧位和旋转DSA造影。结果正侧位造影中16例患者动脉瘤阳性,其中9例动脉瘤和载瘤动脉与周围血管关系显示不清,使用三维重建能在介入手术中为术者提供清晰的工作体位,动脉瘤颈、动脉瘤体、载瘤动脉之间的关系。2例患者使用三维重建后,DSA系统无法到达工作体位,将头颅固定支架旋转改变术中体位,工作角度显示清晰,手术成功。结论在介入手术过程中个别患者的脑动脉扭曲或者先天异常致使最佳工作角度因DSA系统的机械原因无法到达,介入手术的体位改变可以达到由于机械原因无法达到的体位,使术者在动脉瘤介入手术过程中的工作体位有了更多的选择,充分暴露动脉瘤瘤颈,以及载瘤动脉的关系,对介入诊治有着十分重要的作用。Objective To assess the value of rotation digital subtraction angiography combined with the adjusting of patient＇s position in performing the interventional procedure for complicated intracranial aneurysms.Methods Cerebral angiography in both anteroposterior and lateral positions as well as rotational cerebral angiography were carried out in 25 patients by using GE INNOVA 3100 digital subtraction angiography system.The image qualities,the technical feasibility and the operation success rate were analyzed.Results Intracranial aneurysms were detected in 16 patients on anteroposterior position and lateral position angiography.In 9 patients the anatomic relationship between the aneurysms and the related arteries could not be clearly judged on both anteroposterior position and lateral position angiographic images,while it could be well displayed on rotational angiographic images.In two interventional procedures the DSA unit working parts could not reach the optimal position indicated by the 3D-reconstruction images,and the patient＇s head position had to be adjusted with the help of a fixing support in order to let the operation be managed successfully.Conclusion The rotation digital subtraction angiography combined with the adjusting of patient＇s head position can compensate the limitation of DSA unit mechanical working extent,therefore,the interventional procedures can be successfully performed with the patient lying in an ideal and optimal position.

关 键 词：脑动脉瘤 旋转DSA 三维重建 

分 类 号：R651.1[医药卫生—外科学]