静脉3D融合技术辅助评估DAVF引流静脉是否兼具脑静脉回流功能  

Application of 3D venous fusion technology to determine whether the drainage vein of DAVF simultaneously has normal cerebral venous reflux

作　　者：付强[1,2] 李欢欢 陈迎春 林爱龙 宋雪倩 马廉亭 FU Qiang;LI Huan-huan;CHEN Ying-chun;LIN Ai-long;SONG Xue-qiang;MA Lian-ting(Department of Neurosurgery,The Third People's Hospital of Hubei Province,Jianghan University,Wuhan 430032,China;Department of Neurosurgery,Gucheng People's Hospital,Xiangyang 441700,China;Department of Neurosurgery,General Hospital of Central Theater Command,Wuhan 430070,China)

机构地区：[1]江汉大学附属湖北省第三人民医院神经外科,武汉430032 [2]谷城县人民医院神经外科,湖北441700 [3]中部战区总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2024年第3期144-147,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨静脉3D融合技术在确定硬脑膜动静脉瘘(DAVF)的引流静脉是否兼具脑静脉回流功能中的应用价值。方法回顾性分析2021年9月至2023年3月收治的6例伴有皮层静脉引流的DAVF的临床资料。行DSA后,在后处理工作站用“3D双血管融合技术”进行病变引流静脉与正常脑静脉3D融合,分别标记白、蓝色区别,通过血管融合技术可以看到两者有无共同的通路,以确定病变回流静脉是否存在具有正常引流功能。结果6例均获得良好的静脉3D融合影像,双血管融合影像可以清晰看到病变引流静脉(白色)与正常脑回流静脉(蓝色)相重叠,存在共同的通路,即兼具正常脑静脉回流的功能。6例均获得治愈性栓塞,术后复查造影示兼具正常回流功能引流静脉均获得保护,术后未发生颅内出血及脑梗塞等并发症,症状缓解或消失。术后3~6月随访DSA未见DAVF复发。结论应用静脉3D融合技术可帮助判断DAVF引流静脉是否兼具正常脑静脉回流的功能,术中对这类静脉保护可减少手术并发症。Objective To investigate the application value of 3D venous fusion technology in determining whether the drainage vein of dural arteriovenous fistula(DAVF)associated with cortical venous drainage simultaneously has normal cerebral venous reflux.Methods The clinical data of 6 patients with DAVF associated with cortical venous drainage who admitted to our hospital from September 2021 to March 2023 were retrospectively analyzed.The"3D dual vessel fusion technology"was used in the post-processing workstation to perform 3D fusion of fistula drainage veins and normal cerebral veins using DSA data,marked with white and blue to distinguish them,and the two type vessels could be clearly observed by the fusion images to determine if they had a common path,thereby determining whether the drainage vein had normal cerebral venous reflux.Results Good 3D fusion images were obtained in all 6 cases,and the dual vessel fusion images clearly showed that the drainage vein(white)overlapped with the normal cerebral venous reflex(blue)and had a common path,indicating that it had normal cerebral venous reflux.All 6 patients had curative embolization,and postoperative angiography showed that the normal reflux was preserved.No intracranial hemorrhage,or cerebral infarction occurred after surgery,and the symptoms were relieved or disappeared.The DSA follow-up 3~6 months after surgery did not show recurrence of DAVF.Conclusions The 3D venous fusion technology can help determine whether the drainage vein of DAVF associted with cortical venous drainage also has normal cerebral venous reflux.Protecting these veins during surgery can reduce surgical complications.

关 键 词：硬脑膜动静脉瘘 引流静脉 脑静脉回流功能 影像融合技术 静脉3D-DSA 

分 类 号：R739.41[医药卫生—肿瘤]