急性颅内动脉瘤破裂患者显微手术治疗中三维重建CT血管造影对手术效果的评估价值研究  

Evaluation value of three-dimensional reconstructed CT angiography in microsurgical treatment of acute intracranial aneurysm in patients with ruptured intracranial aneurysm

作　　者：白艳花 任涛[2] 田昵军 Bai Yanhua;Ren Tao;Tian Nijun(Department of Imaging,the Third People′s Hospital ofYan′an City,Shaanxi 716000,China;不详)

机构地区：[1]陕西省延安市第三人民医院影像科,716000 [2]延安大学附属医院CT诊断科 [3]陕西省渭南市第一医院神经外科

出　　处：《山西医药杂志》2022年第23期2662-2666,共5页Shanxi Medical Journal

摘　　要：目的分析急性颅内动脉瘤破裂患者显微手术治疗中三维重建CT血管造影(3D-CTA)对手术效果的评估价值。方法通过便利抽样法回顾性研究我院神经外科2021年10月至2022年1月住院的92例急性颅内动脉瘤破裂患者,根据手术方法的不同分2组,每组46例。对照组给予介入栓塞术治疗,观察组给予显微手术治疗,术前、术后7 d,均进行3D-CTA检查,比较2组术前动脉瘤3D-CTA影像学征象、瘤体残留率以及瘤体残留者3D-CTA相关参数。比较2组预后良好率。结果观察组动脉瘤3D-CTA影像学征象光滑型率(21.7%)、乳头+棘突征率(26.1%)、棘突征率(17.4%)、丘状突起征率(21.7%)、乳头征率(13.0%)与对照组(17.4%、21.7%、26.1%、26.1%、8.7%)比较,差异均无统计学意义(P>0.05)。观察组瘤体残留率(6.5%)低于对照组(28.3%),观察组瘤径(D)、瘤体高度(H)、动脉瘤倾斜角度(AA)、大小比值(SR)、长宽比(AR)、瘤体最大直径(Hmax)均低于对照组,差异均具有统计学意义(P<0.05)。观察组预后良好率(87.0%)高于对照组(63.0%),差异均具有统计学意义(P<0.05)。结论显微手术在急性颅内动脉瘤破裂治疗中疗效显著。通过3D-CTA检查,可以判断瘤体影像学特征以及有无瘤体残留,测量瘤体高度等参数,从而对显微手术治疗效果作出准确评价。Objective To analyze the evaluation value of three-dimensional reconstructed CT angiography(3D-CTA)in the microsurgical treatment of patients with acute intracranial aneurysm rupture.Methods The convenience sampling method was used to retrospectively study 92 patients with acute intracranial aneurysm rupture hospitalized in the department of neurosurgery of the third people′s hospital of Yan′an city from October 2021 to January 2022.According to different surgical methods(n=46 in each group),the control group was treated with interventional embolization,and the observation group was treated with microsurgery.3D-CTA was performed before and 7 days after the operation.The 3D-CTA imaging signs of aneurysm before operation,tumor residual rate,tumor size and 3D-CTA-related parameters of body remnants were compared between the two groups.The good prognosis rates of the two groups were compared.Results In the observation group,the rate of aneurysm 3D-CTA imaging signs of smooth type(21.7%),papillary+spinous process sign rate(26.1%),spinous process sign rate(17.4%),mound-like process sign rate(21.7%),papillary sign rate(13.0%)were not statistically different from that indexes in the control group(17.4%,21.7%,26.1%,26.1%,8.7%,P>0.05).The tumor residual rate(6.5%)in the observation group was lower than that in the control group(28.3%),and tumor diameter(D),tumor height(H),aneurysm inclination Angle(AA),size ratio(SR),length-width ratio(AR)and the maximum diameter of the tumor(Hmax)were lower than those in the control group(P<0.05).The good prognosis rate of the observation group(87.0%)was higher than that of the control group(63.0%)(P<0.05).Conclusion Microsurgery is effective in the treatment of acute intracranial aneurysm rupture.Through 3D-CTA examination,it is possible to determine the imaging characteristics of the tumor and the presence or absence of tumor residues,measure the height of the tumor and other parameters,so as to accurately evaluate the effect of microsurgery.

关 键 词：颅内动脉瘤 介入栓塞术 显微手术 三维重建 CT血管造影 

分 类 号：R651.11[医药卫生—外科学]