静脉法三维数字减影脑血管成像初步临床经验  

Initial Clinical Experience of Intravenous Three-Dimensional Digital Subtraction Angiography in Cerebral Vascular

作　　者：姚开情[1] 吕发金[1] 李越[1] 吴家会[1] 勒都晓兰[1] 李剑秋[1] 陈莉[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,400016

出　　处：《临床放射学杂志》2012年第12期1782-1785,共4页Journal of Clinical Radiology

摘　　要：目的探讨静脉法三维数字减影血管成像(intravenous three-dimensional digital subtraction angiography,IV3D DSA)在脑血管中运用的临床可行性,并与容积CT数字减影血管成像(VCTDSA)对照评价其图像质量。方法对21例行VCTDSA的动脉瘤开颅夹闭术后患者同期行IV 3D DSA脑血管成像检查。对比剂从肘前静脉入路,行头部3D DSA,将原始数据传至工作站进行后处理。结果 IV 3D DSA检查中,2例失败,19例成功,20个动脉瘤夹均显示较清晰(其中1例有2个动脉瘤夹),12例清晰显示动脉瘤夹闭完全,载瘤动脉通畅,7例因运动伪影干扰使载瘤动脉显示欠佳,大部分能较好地显示颅内主要大动脉,其中,图像质量Ⅱ级占10.5%(2/19),Ⅲ级占84.2%(16/19),Ⅳ级占5.3%(1/19);对应VCTDSA中,19例动脉瘤夹及载瘤动脉均清晰显示,图像质量Ⅰ级占36.8%(7/19),Ⅱ级占42.1%(8/19),Ⅲ级占21.1%(4/19)。IV 3D DSA与VCTDSA的图像质量差异有统计学意义(Z=-3.782,P<0.05)。结论 IV 3D DSA临床可行,但图像质量不及VCTDSA。IV 3D DSA尚需优化成像参数提高图像质量。Objective To evaluate the feasibility and image quality of intravenous three dimensional digital subtraction angiography（IV 3D DSA）in cerebral vessels. Methods Twenty one patients with intracranial aneurysm clipped surgery underwent IV 3D DSA and VCTDSA. The 3D raw volume data were post processed at 3D workstation. Results In IV 3D DSA, 19 patients succeed in the examination, 20 aneurysm clips were clearly displayed （one patient had two aneurysm clips）. On 3D DSA images,the aneurysms showed completely clipped and the parent arteries were unobstructed in 12 of 19 patients, the parent arteries didn＇ t show clearly because of motion artifacts in 7 of 19 patients. The image quality of grade Ⅱ, Ⅲ, Ⅳ were 10.5% （2/19）, 84.2% （16/19）, 5.3% （1/19） respectively. On VCTDSA imags, all the aneurysm clips and parent arteries showed clearly, and the image quality of grade I , Ⅱ , Ⅲ were 36.8% （7/19）, 42.1% （8/19）, 21.1% （4/19） respectively. Significant difference of image quality was found between IV 3D DSA and VCTDSA （Z = - 3. 782,P 〈 0.05 ）. Conclusion IV 3D DSA can be used to display cerebral vessels and aneurysm,but it still need to im- prove the image quality.

关 键 词：静脉法三维数字减影血管造影 脑血管 图像后处理 

分 类 号：R816.1[医药卫生—放射医学]