颅内动脉瘤囊内栓塞结果影像学判断标准的探讨  

An occlusive evaluation proposal to intra-saccular embolization of intracranial aneurysm

作　　者：王大明[1] 凌锋[1] 李萌[1] 张鸿祺[1] 缪中荣[1] 张鹏[1] 宋庆斌[1] 郝蔓春[1] 张洋[1] 

机构地区：[1]北京医院神经外科,100730

出　　处：《中华外科杂志》2000年第11期844-846,I047,共4页Chinese Journal of Surgery

基　　金：国家自然科学基金!资助项目 (39870 2 2 8)

摘　　要：目的　探讨颅内动脉瘤囊内栓塞结果的影像学判断标准。　方法　 6名专科医师根据动脉瘤栓塞后血管造影不显影为 10 0 %、瘤颈少许残留为 95 %、瘤颈残留为 90 %、瘤颈残留并有少许瘤体残留为 80 %和少部分瘤体残留为 <80 %的栓塞判断标准 ,对 1995年 3月至 1999年 7月用机械可脱式弹簧圈和 (或 )电解可脱式弹簧圈囊内栓塞的 12 0例 (12 1个 )动脉瘤的血管造影片进行评价 ,并分析该标准的合理性、可行性和局限性。　结果　 12 1个动脉瘤中 ,栓塞 <80 %、80 %、90 %、95 %和10 0 %的动脉瘤数依次分别为 10 (8 3% )、15 (12 4% )、16 (13 2 % )、2 7(2 2 3% )和 5 3(4 3 8% )个 ,栓塞80 %～ 10 0 %动脉瘤的平均栓塞率 (94 6 4± 6 80 ) %。不同医师间的栓塞结果评判相互符合性好。　结论　该标准简易可行 ,符合临床实际 ;但栓塞百分比的数值规定有一定的任意性 ,对随访结果的临床指导意义有待进一步探讨。Objective To explore the imaging criteria for evaluating intracranial aneurysm embolization. Methods Angiographic occlusive criteria for tracranial aneurysm embolization (aneurysm not opcified angiographily after embolization, 100% occlusion; a little part of aneurysm neck residual, 95%; neck residual, 90%; neck and a little part of aneurysm cavity residual, 80%; some cavity residual, <80%) were used by 6 specialists to evaluate 121 aneurysms embolized with MDS (mechanical detachable spiral) or/and GDC (guglielmi detachable coil) from March 1995 to July 1999. The rationality, feasibility and limitation of the criteria were discussed. [WT5”HZ]Results[WT5”BZ] Among the 121 aneurysms, 100% occlusion was reached in 53 aneurysms (43 8%), 95% in 27(22 3%), 90% in 16(13 2%), 80% in 15(12 4%), and less than 80% in 10(8 3%) respectively. Good accordance was obtained among different doctors in the occlusive evaluation of aneurysm embolization. [WT5”HZ] Conclusions[WT5”BZ] The suggesting criteria are simple and feasible in clinical practice, although the effect of imaging follow up of embolized aneurysm is unknown and the numerical value of occlusive percentage is arbitrary.

关 键 词：颅内动脉瘤 影像学诊断 囊内栓塞治疗 

分 类 号：R739.410.4[医药卫生—肿瘤]