MRI与3D-DSA融合技术在脑动静脉畸形手术的应用研究  

Application of MRI and 3-dimension DSA image fusion technology in the surgical treatment of cerebral arteriovenous malformation

作　　者：张翔圣[1] 张鑫[1] 张庆荣[1] 吴琪[1] 文立利[1] 茅磊[1] 吴伟[1] 杭春华[1] 

机构地区：[1]南京军区南京总医院神经外科,江苏南京210002

出　　处：《中华神经外科疾病研究杂志》2016年第4期334-337,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(81471183);江苏省自然科学基金资助项目(BK20141377)

摘　　要：目的初步探讨磁共振成像(MRI)与三维数字减影血管造影(3D-DSA)图像融合技术在颅内动静脉畸形(AVM)手术中的应用价值。方法回顾分析南京军区南京总医院神经外科2015年1月至2015年4月诊断明确为AVM的6例患者,术前均行MRI与3D-DSA检查,并行MRI与3DDSA影像融合。根据MRI与3D-DSA融合图像进一步制定手术方案行显微直视手术切除。结果所有患者MRI与3D-DSA融合图像不仅可清楚的显示AVM与周围神经结构之间的空间关系,同时对部分合并微小动脉瘤或小血管畸形的患者可清晰的显示病变在血肿或脑组织之间的位置。所有患者行显微直视手术切除术后均恢复良好,复查脑血管造影未见明显畸形血管团残留。术后6例患者均行MRI随访,AVM均无复发,同时未有新发神经功能障碍及再出血。结论 MRI与3D-DSA融合图像可为显微外科手术切除AVM提供更多重要信息,有效的辅助AVM手术的术前规划。Objective The applicative value of magnetic resonance imaging （MRI） and 3-dimension DSA （3D-DSA） image fusion technology in the surgical treatment of intracranial arteriovenous malformation （AVM） is dicussed. Methods The clinical data of 6 patients, which were diagnosed as AVM from January 2015 to April 2015 in the department of neurosurgery, General Hospital of Nanjing Military Command, were analyzed retrospectively. The MRI and 3D-DSA were performed, and the fusion images were achieved before surgery in each patient. All the AVMs were operated with microsurgical strategy depended on the fusion images. Results TheMRI and 3D-DSA fusion images showed clearly the relationship between the AVMs and peripheral nerve structure in all the patients. Moreover, it could display the orientation between the lesions and the hematoma, and brain structure in patients with small aneurysms or AVMs. All the patients had a good recovery after microsurgery, and no obvious residue of lesions was seen by post-operative DSA. Six patients were followed up with MRI, and there was no recurrence of the AVMs. No new neurological disturbance or rebleeding was found in all the patients. Conclusion MRI and 3D-DSA image fusion technology can provide much more important information for the microsurgieal strategy and the treatment of AVM.

关 键 词：颅内动静脉畸形 磁共振成像 三维数字减影血管造影 融合 

分 类 号：R743.4[医药卫生—神经病学与精神病学]