透视三维路径图指引在颅内动脉瘤栓塞中的应用  

3D fluoroscopic roadmap guidance in embolization of intracranial aneurysms

作　　者：朱栋梁[1] 陈胜利[1] 陈国东[1] 黄子诚[1] 

机构地区：[1]广州市第一人民医院介入放射科,广东广州510180

出　　处：《影像诊断与介入放射学》2014年第1期33-36,共4页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨颅内动脉瘤介入栓塞术中，透视三维路径图指引技术的应用方法和临床价值。方法2010年8月－2012年6月在我院使用同一台DSA机实施单个颅内动脉瘤栓塞术的患者61例，分A、B两组。A组25例患者采用常规二维路径图指引技术进行颅内动脉瘤介入栓塞，B组36例患者均在透视三维路径图的实时指引下进行介入栓塞操作。分别记录A、B两组的栓塞治疗时间、总体透视时间、总体透视入射表面剂量、动脉瘤栓塞程度等数据，进行对比分析。由有经验的做颅内动脉瘤栓塞的手术医师分别对两种指引技术进行主观评分并做对比分析。结果A、B两组在栓塞治疗时间、总体透视时间、总体透视入射表面剂量均有显著性差异，B组比A组分别减少了23％、16％、30％。A、B两组在动脉瘤栓塞程度上不具有显著性差异（P=0．990）；两种指引方法在手术医师主观评价上具有显著性差异（P=0．000），透视三维路径图指引评分高于常规二维路径图指引。结论使用透视三维路径图指引技术进行颅内动脉瘤的介入栓塞，指引图像清晰、操作简便，可以提高手术医师操作信心和效率，从而提高手术安全性、缩短手术时间、减少患者和医生的x射线辐射，具有很高的临床应用价值。Objective To explore the value of 3D fluoroscopic roadmap guiding technique in embolization of intracranial aneurysms. Methods 61 patients underwent embolization treatment of solitary intracranial aneurysms from August 2010 to June 2012. The patients were randomly divided into a group （25） using conventional 2D and a group （36） using 3D fluoroscopic roadmap guiding techniques. The duration of the entire procedure and fluoroscopy, entrance surface dose （ESD）, and degree of aneurysm embolization were recorded. The two techniques were subjectively scored by an experienced interventional neuroradiologist and compared. Results The duration of the procedure and fluoroscopy time as well as the ESD were significantly （P 〈 0.05） reduced by 23%, 16% and 30%, respectively with the 3D fluoroscopic roadmap. The difference of aneurysm embolization was not significant （P = 0.99）. The score of the 3D fluoroscopic roadmap was significantly higher than that of conventional 2D roadmap （P = 0）. Conclusions 3D fluoroscopic roadmap guiding technique is convenient and safe with high image quality and reduced procedure time and radiation exposure.

关 键 词：透视三维路径图指引 颅内动脉瘤 栓塞 

分 类 号：R816.2[医药卫生—放射医学] TP391.41[医药卫生—临床医学]