双血管融合技术在硬脑膜动静瘘诊断和手术计划中的应用  

Application of dual vessel fusion technique in the diagnosis of dural arteriovenous fistula and surgical planning

作　　者：盛柳青[1] 李俊[1] 李国栋[1] 李欢欢[1] 陈刚[1] 向伟楚[1] 王强[1] 甘志强[1] 马廉亭[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070

出　　处：《中华神经外科杂志》2015年第8期768-771,共4页Chinese Journal of Neurosurgery

基　　金：湖北省医学临床研究中心项目（JX4D12）湖北省科技计划研究与开发项目（2010BCB012）湖北省自然科学基金（2011CDC156）

摘　　要：目的 探讨双血管融合技术在硬脑膜动静瘘（dural arteriovenous fistula,DAVF）诊断和手术计划中的应用价值,指导术中准确找到瘘口.方法 在10例DAVF病例采用平板DSA行选择性全脑血管造影,病变血管行三维血管成像.在三维工作站采用“双容积重建”技术进行两支血管三维像的融合,研究DAVF的血管构筑.结果 在10例均获得满意的“双血管融合”,具有很好的空间一致性.在双血管融合图像上可以清晰看到来自不同供血动脉的血流汇流到同一瘘口和引流静脉（表现为红白相间的血流融合）,可以清晰判断瘘口的部位和形态,指导选择治疗策略、设计外科手术和介入手术计划.结论 基于平板DSA三维血管数据的“双血管融合”可以获得准确的血管融合,更清晰地显示瘘口、供血动脉、引流静脉等DAVF的血管构筑学信息,最终有益于治疗外科手术计划.Objective To investigate the application values of dual vessel fusion technique in the diagnosis of dural arteriovenous fistula （DAVF） and surgical planning.Methods Ten patients with DAVF underwent selective cerebral angiography using plate digital subtraction angiography （DSA）.The lesion vessels performed three-dimensional angiography.The ＂double volume reconstruction＂ technique was used to perform two-vessel three-dimensional image fusion at the three-dimensional workstation.The angioarchitecture of DAVF was investigated.Results Ten patients obtained satisfactory ＂dual vessel fusion＂ with a good spatial coherence.On the dual vessel fusion images,the blood flow from different feeding arteries flowed together into the same fistula and draining vein （presented as a fusion of red and white blood flow） and the location and shape of the fistula cold be identified clearly.It could be used to guide the choice of treatment strategy,design surgery and surgical intervention plan.Conclusions Based on the ＂dual vessel fusion＂ of fiat panel DSA three-dimensional vascular data,it can obtain accurate vascular fusion,more clearly reveal fistulas,feeding arteries,draining veins and other angioarchitecture information of DAVF,and ultimately be beneficial to the development of surgical planning.

关 键 词：硬脑膜动静脉瘘 双容积重建 手术计划 

分 类 号：R651.1[医药卫生—外科学]