三维数字减影血管造影在脑血管病诊断和介入治疗中的价值  

Value of three demensional digital subtraction angiography in diagnosis and planning endovascular treatment of cerebrovascular diseases

作　　者：杨华[1] 刘健[1] 韩国强[1] 孙业忠[1] 刘窗溪[1] 陈益民[1] 高方友[1] 周石[2] 宋杰[2] 马宁[2] 唐家强[2] 许红[2] 吴晓萍[2] 

机构地区：[1]贵阳医学院附属医院神经外科,550004 [2]贵阳医学院附属医院介入科,550004

出　　处：《中华医学杂志》2002年第10期661-664,共4页National Medical Journal of China

基　　金：贵州省省长专项基金资助项目 (2 0 0 1 14 )

摘　　要：目的　探讨三维数字减影血管造影 (3D DSA)在脑血管疾病中的诊断和血管嫩治疗的价值。方法　 4 0例疑有脑血管病的患者均在 3D DSA系统的操作床上行普通DSA ,然后行三维重建成像处理作出正确的诊断 ,再根据 3D DSA处理图片数据拟定介入治疗方案。结果　 4 0例疑有脑血管病的患者均行普通DSA检查 ,阳性率为 85 0 % ,3D DSA处理后阳性率为 95 0 %。共确诊 38例 ,其中脑动脉瘤 15例 ,GDC栓塞治疗 13例 ,10 0 %栓塞 11例 ,90 %以上栓塞 2例。脑动静脉畸形 9例 ,10 0 %栓塞 7例 ,90 %以上栓塞 2例。缺血性中风 14例 ,其中血管狭窄 9例 ,支架置入 8例 ,7例狭窄血管 10 0 %开通 ;血管闭塞 5例 ,尿激酶动脉内溶栓治疗 ,完全再通 2例 ,部分再通 2例 ,不通 1例。并发症 3例 (7 9% )。结论　 3D DSA能够提高脑血管病的检出率 ,明显优于普通DSA ,对评价脑血管病的血管内治疗有潜在的价值。Objective To evaluate the value of three demensional(3D) digital subtration angiography (DSA) in diagnosis and planning endovascular treatment of cerebrovascular diseases. Methods Standard DSA and 3D DSA were performed in 40 adult patients (aged 21～74 years) suspected to be with cerebrovascular diseases.The schemes of endovascular treatment were worked out according to the results of 3D DSA. Results Positive rate of standard DSA and 3D DSA were 85.0% and 95.0% respectively in diagnosis of cerebrovascular diseases. 100% occlusion was achieved in 11 patients with intracranial aneurysms and in 7 patients with arteriovenous malformations,and 100% recanalization was achieved in 9 patients with ischemic stroke. Temporary complications were found in 3 of all patients( 7.9% ). Conclusions 3D DSA is an ideal tool superior to standard DSA in diagnosis of cerebrovascular diseases and has potential value for evaluating endovascular treatment of cerebrovascular diseases.

关 键 词：三维数字减影血管造影 脑血管病 诊断 介入治疗 

分 类 号：R743.044.5[医药卫生—神经病学与精神病学]