荧光显影技术在岩上窦区硬膜动静脉瘘术中鉴别正常岩上静脉的临床应用  

Using indocyanine green video-angiography to preserve normal petrosal veins in the microsurgical treatment of the superior petrosal sinus dural arteriovenous fistulas

作　　者：孙力泳[1] 任健[1] 李静伟[1] 何川[1] 叶明[1] 李桂林[1] 李萌[1] 张鹏[1] 张鸿祺[1] Sun Liyong;Ren Jian;Li Jingwei;He Chuan;Ye Ming;Li Guilin;Li Meng;Zhang Peng;Zhang Hongqi(Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经外科,北京100053

出　　处：《中国脑血管病杂志》2020年第4期181-185,204,共6页Chinese Journal of Cerebrovascular Diseases

基　　金：2017年度北京市委组织部优秀人才培养资助项目(2017000020124G236)。

摘　　要：目的 探讨应用吲哚氰绿荧光显影技术在外科治疗岩上窦区硬脑膜动静脉瘘术中鉴别保护正常岩上静脉的应用体会.方法 回顾性分析首都医科大学宣武医院应用吲哚氰绿荧光显影技术治疗的10例岩上窦区硬膜动静脉瘘的病例资料,判定动静脉瘘口位置,辨别正常的岩上静脉.术后行影像学复查,并以改良Rankin量表(mRS)评分评价临床疗效.结果 10例患者中,6例术中发现伴发正常岩上静脉,均应用吲哚氰绿荧光显影技术加以辨别保护.10例病例均经术后随访血管造影证实瘘口离断,术后无新发并发症.术后随访mRS评分:7例0~1分,2例2分,1例3分.结论 岩上窦区硬脑膜动静脉瘘可伴有正常引流功能的岩上静脉,术中需保留;术中吲哚氰绿荧光显影技术有助于分辨并保护岩上静脉,防止该静脉损伤而引起并发症.Objective To investigate the efficiency of indocyanine green video-angiography(ICGV)for the identification of normal superior petrosal vein(SPV)in the treatment of the superior petrosal sinus dural arteriovenous fistulas(SPS-DAVFs).Methods Ten cases with SPS-DAVFs in Xuanwu Hospital were analyzed retrospectively.The ICGV was used to confirm the location of the fistula and identify the normal SPV.The postoperative radiological examination was performed,and the clinical outcome was evaluated with the modified Rankin scale(mRS).Results Coexistent normal functional SPV was found in 6 cases of 10 cases.The DAVFs were nicely-identified and disrupted by using intraoperative ICGV.The normal SPVs were also successfully preserved.The whole 6 cases experienced good clinical and radiological outcomes.Conclusions SPS-DAVFs can coexist with normal functional SPV,which should be carefully preserved.ICGV technique is an efficient way for the identification of normal SPV.

关 键 词：硬脑膜动静脉瘘 岩上窦区 岩上静脉 吲哚氰绿荧光显影 

分 类 号：R651.1[医药卫生—外科学]