三维DSA彩色融合技术在大脑中动脉远端血管介入术中导航定位的应用  

The application of 3D-DSA color fusion technique in interventional intraoperative navigation and positioning of the distal vessels of middle cerebral artery

作　　者：胡鑫 蒲先智 陈林 彭汤明 刘勇贵 孙晓磊 HU Xin;PU Xianzhi;CHEN Lin;PENG Tangming;LIU Yonggui;SUN Xiaolei(Department of Interventional Medicine,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan Province 646000,China)

机构地区：[1]西南医科大学附属医院介入医学部,四川泸州646000 [2]西南医科大学附属医院神经外科,四川泸州646000

出　　处：《介入放射学杂志》2022年第6期538-542,共5页Journal of Interventional Radiology

基　　金：四川省心血管疾病防治协同创新中心项目(xtcx2019-20);医学电生理学教育部重点实验室(西南医科大学)开放基金(KeyME-2018-04);核医学与分子影像四川省重点实验室课题项目(HYX19007)。

摘　　要：目的 评价三维DSA彩色融合技术在大脑中动脉远端血管介入术中导航定位的价值.方法 选取2018年6月至2020年12月在西南医科大学附属医院接受大脑中动脉远端动静脉畸形和动脉瘤介入治疗患者36例.随机将患者分为实验组(n=17,术中采用三维DSA彩色融合技术辅助导航)和对照组(n=19,采用二维路径图导航).观察两组手术时间、术中微导管超选病变血管导引时间、X线透视时间、对比剂用量、辐射剂量[空气比释动能(AK)、剂量-面积乘积(DAP)]、手术相关并发症等情况.结果 实验组、对照组间手术时间[(95.80±12.50)min比(103.70±9.60)min]、微导管导引时间[(5.82±1.94)min比(8.47±2.48)min]、X线透视时间[(35.76±4.72)s比(51.16±5.80)s]、对比剂用量[(27.06±2.77)mL比(33.05±5.46)mL]、辐射剂量[AK:(88.48±21.67)mGy比(234.99±40.60)mGy,DAP:(7.11±1.07)Gyc/m2比(13.40±3.34)Gyc/m2,]差异有统计学意义(均P<0.05),对照组有2例术后2 d发生对比剂肾病.实验组术中导引难度较对照组明显降低(P<0.01).结论 三维DSA彩色融合技术应用于大脑中动脉远端血管超选导航定位,具有可靠性高,术中导引时间短、辐射剂量低、对比剂用量低,手术效率高等优势,具有较高的辅助价值.Objective To assess the value of three-dimensional digital subtraction angiography(3D-DSA)color fusion technique in interventional intraoperative navigation and positioning of the distal vessels of middle cerebral artery.Methods A total of 36 patients with arteriovenous malformation(AVM)or aneurysm located at the distal vessels of middle cerebral artery,who received interventional treatment at the Affiliated Hospital of Southwest Medical University of China between June 2018 and December 2020,were enrolled in this study.The patients were randomly divided into study group(n=17,using 3D-DSA color fusion navigation technique)and control group(n=19,using conventional 2D-roadmap navigation technique).The time spent for operation,time spent for microcatheter superselective catheterization of diseased vessel,fluoroscopic time,used amount of contrast agent,radiation dose including air specific release kinetic energy(AK)and dose-area product(DAP),and procedure-related complications in both groups were recorded.Results In the study group and the control group,the time spent for operation was(95.8±12.5)minutes and(103.7±9.6)minutes respectively,the time spent for microcatheter superselective catheterization of diseased vessel was(5.82±1.94)minutes and(8.47±2.48)minutes respectively,the fluoroscopic time was(35.76±4.72)seconds and(51.16±5.80)seconds respectively,the used amount of contrast agent was(27.06±2.77)mL and(33.05±5.46)mL respectively,AK was(88.48±21.67)mGy and(234.99±40.60)mGy respectively,DAP was(7.11±1.07)Gyc/m2 and(13.40±3.34)Gyc/m2 respectively;the differences in all the above indexes between the two groups were statistically significant(all P<0.05).In the control group,2 patients developed contrast-induced nephropathy two days after treatment.The difficulty degree of navigating catheterization in the study group was remarkably lower than that in the control group(P<0.01).Conclusion In navigating superselective catheterization of the distal vessels of middle cerebral artery,3D-DSA color fusion techn

关 键 词：三维数字减影血管造影 影像融合 大脑中动脉 介入手术导航 

分 类 号：R739.4[医药卫生—肿瘤]