颈内动脉动脉瘤3D—DSA重建成像的构型分析  

Configuration analysis of 3D - DSA reconstruction imagings of internal carotid artery （ ICA ） aneurysm

作　　者：刘军[1] 王霞[2] 王浩洲[1] 王琳[1] 李吉贞[1] 张明然[3] 王莲[1] 

机构地区：[1]山东省泰安市中心医院放射介入科,271000 [2]山东省泰安市中心医院影像中心,271000 [3]山东省泰安市中心医院神经外科,271000

出　　处：《中华神经外科杂志》2013年第4期394-398,共5页Chinese Journal of Neurosurgery

摘　　要：目的分析颈内动脉（ICA）动脉瘤在3D—DSA中的三维构型特点，探讨其指导临床的意义。方法回顾性总结77例ICA动脉瘤患者3D—DSA的影像资料，对77例107个动脉瘤应用Syngo Inspace软件任务卡进行重建成像，显示其三维容积及三维形态结构，研究动脉瘤形态与ICA及其分支动脉开口的结构关系。结果按ICA Bouthillier分段，动脉瘤在C4-C5段4个，C6-C7段（床突上段）103个。动脉瘤以类圆形鼓泡状形态自ICA凸起，其形态可分为单泡型74个（69．2％）、双泡型21个（19．6％）、多泡型12个（11．2％），双泡型及多泡型动脉瘤以圆泡连体的方式沿颈动脉轴线排列，不会横向排列。其中单泡型动脉瘤又分为单泡漏斗型、单泡水泡型、单泡窄颈型及单泡宽颈型。根据动脉瘤瘤颈开口与ICA及其分支动脉开口的关系，又可将动脉瘤分为分支无关型、分支相关型和分支泡上发出型，分别有51个、37个和19个。结论根据3D—DSA可了解ICA动脉瘤的部位、形态结构，尤其是动脉瘤开口与ICA及其分支动脉开口的结构关系，对临床选择治疗方法，以及对治疗过程中容易产生的问题、术后疗效的判断都具有重要的指导意义。Objective To study the three- dimensional configuration characteristic of internal carotid artery （ ICA ） aneurysrrs in 3D - DSA reconstruction imaging, and to discusses its guiding meaning for clinical teeatment of ICA aneurysrrt Methods Retrospective analysis of 77 patients with ICA aneurysms. There were 107 aneurysms in 77 cases. Syngo Inspace software was used to reconstruct imaging to display three -dimensional volume and structure of the carotid artery aneurysm, and to study the space structure relationship of aneurysm with the ICA and branch artery. Resdts According to the Bouthillier segmentation of ICA. There were 4 aneurysms occurred in C4 -C5 ,and 1（13 in C6 -C7 （ supraclinoidal segrnent ）. The aneurysms protrude from ICA with a series of circular bubble shapes, the shapes can be divided as following： single bubble type were 74 accounting for 69. 2% ,double bubble type were 21 accounting for 19. 6%, multiple bubble type were 12 accounting for 11.2%. The double bubble type and nmltiple bubble type conjoined together aligned with the ICA, not horizontal arranged. The single bubble type can be divided into single bubble funnel type, single bubble blister type, single bubble narrow neck type and single bubble wide - necked type. According to the relationship of aneurysm neck openings and carotid artery openings, aneurysm can also be divided into branch-unrdated type aneurysm, branch-related aneurysms and branch on bubble type aneurysm, and there were 51,37 and 19 respectively. Conclusions According to 3D -DSA reconstruction imagings of the ICA aneurysms,the position and morphology of ICA aneurysm, especially the spatial position relationship of aneurysms openings and ICA and its brunch openings can be easily get. It is irrgoortant for clinical treatment choice such as operation clipping and coil embolization. It also has important guiding meaning for the problem easily produced during the treatment process and the evaluation of curative effect.

关 键 词：动脉瘤 颈内动脉 血管造影术 数字减影 成像 三维 

分 类 号：R816[医药卫生—放射医学] R74[医药卫生—临床医学]