脑血管造影数字化三维重建联合Smart Mask技术在颅内动脉瘤栓塞诊疗中的应用  

Application of digital three-dimensional reconstruction of cerebral angiography combined with Smart Mask technique in the diagnosis and treatment of embolism of intracranial aneurysms

作　　者：黄华东[1] 黄海能[1] 李传玉[1] 黄才明 罗琨祥[1] 栗学玉[1] HUANG Huadong;HUANG Haineng;LI Chuanyu;HUANG Caiming;LUO Kunxiang;LI Xueyu(Department of Neurosurgery,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Department of Radiology,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]右江民族医学院附属医院神经外科,广西百色533000 [2]右江民族医学院附属医院放射科,广西百色533000

出　　处：《右江医学》2023年第2期109-114,共6页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180200)。

摘　　要：目的研究脑血管造影数字化三维重建(3D-DSA)联合Smart Mask技术应用于颅内动脉瘤栓塞微创诊疗的术前、术中评估及栓塞微创诊疗过程中的应用价值。方法采用前瞻性研究的方法,连续收集2019年1月至2020年6月右江民族医学院附属医院神经外科收治的59例颅内动脉瘤行血管栓塞微创诊疗的患者为对象,患者均采取常规治疗,行数字化三维重建+Smart Mask技术的31例患者为研究组,行数字化三维重建+常规路径图的28例患者为对照组。观察两组性别、年龄、瘤体大小、瘤体位置、破裂动脉瘤例数、PHASES评分、术前Hunt-Hess分级、术中对比剂用量、X线曝光量、手术时间、术中Raymond分级及术后康复情况等相关指标。结果使用Smart Mask技术的研究组和对照组在性别(P=0.763)、年龄(P=0.901)、瘤体大小(P=0.069)、瘤体位置(P=0.314)、破裂动脉瘤例数(P=0.964)、PHASES评分(P=0.314)、术前Hunt-Hess分级(P=0.945)、术中Raymond分级(P=0.600)、改良Rankin量表(mRS)评分(P=0.883)等方面差异无统计学意义(P>0.05)。而使用Smart Mask技术的研究组手术时间短于对照组,X线曝光量、对比剂用量少于对照组(P均<0.01)。结论在血管内治疗过程中运用Smart Mask技术可以有效缩短手术时间,减少X线辐射量和对比剂的用量,降低手术过程中的风险。Smart Mask技术与常规路径图在瘤体栓塞效果上无明显差异,但对于患者术后远期预后的影响仍需要进一步的临床观察与研究。Objective To study the application and value of three-dimensional digital subtraction angiography(3D-DSA)combined with Smart Mask technology in the preoperative and intraoperative evaluation and minimally invasive diagnosis and treatment of embolism of intracranial aneurysms.Methods Prospective study method was used,and 59 patients with intracranial aneurysms who underwent minimally invasive diagnosis and treatment of embolism of intracranial aneurysms in the Department of Neurosurgery of the Affiliated Hospital of Youjiang Medical University for Nationalities from January 2019 to June 2020 were selected as study subjects.All patients were given routine treatment.31 patients who underwent 3D-DSA+Smart Mask technology were selected as study group,and 28 patients who underwent 3D-DSA+routine path map were selected as control group.Gender,age,tumor size,tumor location,number of ruptured aneurysms,PHASES score,preoperative Hunt-Hess grade,intraoperative contrast agent dosage,X-ray exposure,operation time,intraoperative Raymond grade and postoperative rehabilitation were observed in the two groups.Results The study group using Smart Mask technology and the control group were not statistically significantly different in gender(P=0.763),age(P=0.901),tumor size(P=0.069),tumor location(P=0.314),and the number of ruptured aneurysms(P=0.964),PHASES score(P=0.314),preoperative Hunt-Hess grade(P=0.945),intraoperative Raymond grade(P=0.600),modified Rankin scale(mRS)score(P=0.883),etc(P>0.05).However,the operation time of the study group using Smart Mask technology was shorter than that of the control group,and the amount of X-ray exposure and contrast agent consumption were less than those of the control group(all P<0.01).Conclusion The application of Smart Mask technology in endovascular therapy can effectively shorten the operation time,reduce the amount of X-ray radiation and contrast agent,and reduce the risk of operation.There is no significant difference in the effect of tumor embolization between Smart Mask technique a

关 键 词：数字化三维重建 数字减影血管造影 Smart Mask技术 路径图 颅内动脉瘤栓塞 

分 类 号：R739.41[医药卫生—肿瘤]