双容积重建技术在颅内宽颈动脉瘤栓塞术后的应用价值  

Application value of dual volume reconstruction technology in intracranial wide-necked aneurysms after embolization

作　　者：尹姬[1] 杨振兴[2] 黄德俊[2] 马菁[1] 余景科 YIN Ji;YANG Zhenxing;HUANG Dejun;MA Jing;YU Jingke(Radiocatheter Room,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Neurosurgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院放射导管室,宁夏银川750004 [2]宁夏医科大学总医院神经外科,宁夏银川750004

出　　处：《实用放射学杂志》2021年第9期1521-1524,1535,共5页Journal of Practical Radiology

基　　金：宁夏回族自治区重点研发计划项目(2018BEG03021).

摘　　要：目的探讨平板数字减影血管造影G三维旋转血管造影(DSA-3DRA)双容积重建技术(DVRT)在支架辅助弹簧圈栓塞颅内宽颈动脉瘤(IWA)术后的应用价值.方法选取接受介入栓塞治疗的IWA患者35例,均进行支架辅助弹簧圈栓塞治疗术,术后分别在即刻、3、6、12个月行DSA-3DRA复查.复查结果的DSA-3DRA原始数据传输至Philips Allura X-per DSA Xtravision 3D后处理工作站,应用DVRT进行图像后处理并分析图像,对IWA栓塞效果进行评估.结果35例患者共发现IWA37枚(2例为颅内多发动脉瘤),37枚动脉瘤均进行支架辅助弹簧圈栓塞治疗,术后均行复查随访,其中Ⅱ级栓塞3枚(8%),Ⅲ级栓塞1枚(3%),其余33枚均为Ⅰ级栓塞(89%).通过DVRT可以显示辅助支架形态,有2枚辅助支架发生支架内血管狭窄,余35枚辅助支架打开情况良好,血流导向能力及栓塞辅助效果佳.结论DVRT对支架辅助弹簧圈栓塞IWA的治疗效果评估全面、直观、准确,对手术医师的术后治疗以及可能的及时再手术计划有着重要的参考价值,预估且有效地防止了动脉瘤再出血的发生.Objective To investigate the application value of dual volume reconstruction technology(DVRT)of the panel digital subtraction angiography-3D rotational angiography(DSA-3DRA)in intracranial wide-necked aneurysms(IWA)performed stent-assisted coil embolization.Methods 35 cases of patients who had IWA and were performed embolization treatment were selected.All patients underwent stent-assisted coil embolization therapy.DSA-3DRA review was performed immediately,3 months,6 months,and 12 months after the treatment.The DSA-3DRA raw data of the review results was transferred to Philips Allura X-per DSA Xtravision 3D workstation.The embolization effect of IWA was evaluated by image post-processing and analysis base on DVRT.Results A total of 37 IWA were found in 35 patients(2 cases with multiple intracranial aneurysms),and all these patients were treated with stent-assisted coil embolization.The follow-up results:3 cases(8%)were grade Ⅱ embolization;1 case(3%)was grade Ⅲ embolization;and the remaining 33 aneurysms were grade Ⅰ embolization(89%).The shapes of auxiliary stents were displayed by using DVRT,35 auxiliary stents were well opened,with well blood flow guiding ability and embolization assistance effect,except that the two had intra-stent vascular stenosis.Conclusion DVRT is comprehensive,intuitive and accurate in evaluating the treatment effect of stent-assisted coil embolization for IWA.lt has important reference value for surgeon’s postoperative treatment and possible timely reoperation plan.It can predict and effectively prevent the occurrence of aneurysm rebleeding.

关 键 词：双容积重建技术 支架辅助弹簧圈栓塞 颅内宽颈动脉瘤 

分 类 号：R814.43[医药卫生—影像医学与核医学] R815[医药卫生—放射医学]