3D-数字减影血管造影技术用于破裂颅内动脉瘤神经介入术中的价值观察  

Value of 3D digital subtraction angiography in neurointerventional surgery for ruptured intracranial aneurysm

作　　者：陈京翔 吉盛超 叶黛西 耿承军 Chen Jingxiang;Ji Shengchao;Ye Daixi;Geng Chengjun(Department of Medical Imaging,No.904 Hospital of Joint Logistics Support Force of PLA,Wuxi 214000,China)

机构地区：[1]联勤保障部队第九〇四医院医学影像科,江苏无锡214000

出　　处：《海军医学杂志》2024年第9期960-964,共5页Journal of Navy Medicine

摘　　要：目的 探讨3D-数字减影血管造影(DSA)技术在破裂颅内动脉瘤神经介入术中的应用价值。方法 回顾性分析联勤保障部队第九○四医院2020年1月至2023年3月176例行破裂颅内动脉瘤神经介入术患者的临床资料,患者均通过CT血管造影术提示颅内动脉瘤存在,且均行2D-DSA及3D-DSA检查。记录比较2种检查对患者介入治疗后远端血管及分支的显示情况、不同形态动脉瘤的检出情况、动脉瘤瘤颈与载瘤动脉关系的显示情况及动脉瘤穿通血管的显示情况。结果2D-DSA与3D-DSA技术在远端血管及分支显示方面,组间比较差异无统计学意义(P>0.05)。在2D-DSA检查中,检出动脉瘤157例,检出率为89.20%;在3D-DSA检查中,检出动脉瘤175例,检出率为99.43%。3D-DSA动脉瘤检出率高于2D-DSA,差异有统计学意义(P<0.05);且在3D-DSA检查中普通囊状动脉瘤检出率(66.86%)高于2D-DSA检查(47.16%),差异有统计学意义(P<0.05)。在2D-DSA检查中,共108例(61.36%)动脉瘤瘤颈与载瘤动脉关系显示不明确,高于3D-DSA检查(13.64%);共有68例(38.64%)动脉瘤瘤颈与载瘤动脉关系显示明确,低于3D-DSA检查(86.36%),差异有统计学意义(P<0.05)。在2D-DSA检查中,未检出穿通血管,而在3D-DSA检查中,共检出20例(11.36%)穿通血管,差异有统计学意义(P<0.05)。结论 3D-DSA技术应用于破裂颅内动脉瘤神经介入术可提高动脉瘤检出率,对动脉瘤形态及其与载瘤动脉的关系有较高价值。Objective To explore the value of 3D digital subtraction angiography(DSA)in neurointerventional surgery for ruptured intracranial aneurysm.Methods Clinical data of 176 patients with ruptured intracranial aneurysms who underwent neurointerventional surgery at No.904 Hospital of Joint Logistics Support Force from January 2020 to March 2023 were retrospectively analyzed.All patients were diagnosed with intracranial aneurysms through CT angiography and underwent 2D and 3D DSA examinations.The display of distal blood vessels and branches,detection rates of aneurysms,display of the relationship between the aneurysm neck and parent artery,and display of the vessels penetrated by aneurysms were recorded.Results There was no significant difference between the 2D-DSA and 3D-DSA technologies in displaying distal blood vessels and branches(P>0.05).The detection rate of aneurysms by 3D-DSA was 99.43%(175/176),which was significantly higher than that by 2D-DSA(89.20%,157/176),with statistical difference(P<0.05).The detection rate of common cystic aneurysm by 3D-DSA was significantly higher than that by 2D-DSA(66.86%vs 47.16%,P<0.05).Unclear relationship between the aneurysm neck and parent artery was found in 108 patients(61.36%)by 2D-DSA and in 68 patients(38.64%)by 3D-DSA(13.64%),and there was significant difference in the detection rate of the unclear relationship between 2D-DSA and 3D-DSA(P<0.05).No penetrating blood vessels were detected by 2D-DSA,while 20(11.36%)penetrating blood vessels were detected by 3D-DSA(P<0.05).Conclusion 3D-DSA technique can improve the detection rate of aneurysms,and has high diagnostic value for the morphology of aneurysms and their relationship with the parent artery.

关 键 词：破裂颅内动脉瘤 神经介入术 3D-数字减影血管造影 载瘤动脉 

分 类 号：R739.41[医药卫生—肿瘤]