三维旋转数位减影血管造影和三维图像重建技术在内脏动脉瘤介入治疗中的应用

Application of Three-Dimensional Rotational Digital Subtraction Angiography and Three-Dimensional Reconstruction Technique in the Interventional Treatment of Visceral Artery Aneurysm

目的:评价三维旋转数位减影血管造影(digital subtraction angiography,DSA)和三维图像重建技术在内脏动脉瘤介入治疗中的应用价值。方法:选择2007年1月—2015年8月在复旦大学附属中山医院介入治疗科于介入栓塞治疗前行三维旋转DSA和三维图像重建的内脏动脉瘤患者25例,应用Siemens Artis DTA或Philips Allura F20 DSA机行靶血管的三维旋转DSA并进行三维图像重建,与常规二维DSA进行对比。结果:25例患者中肝动脉瘤8例,脾动脉瘤10例,胃十二指肠动脉瘤3例,肾动脉瘤3例,胰十二指肠下动脉瘤1例。所有患者三维旋转DSA均获得成功,技术成功率100%。三维旋转DSA和三维重建图像均能清楚显示动脉瘤的载瘤动脉直径、瘤颈和瘤腔等解剖学信息。25例患者共发现30个动脉瘤。常规二维DSA仅明确诊断了30个动脉瘤中的27个,而且15个动脉瘤瘤颈由于动脉瘤瘤腔较大重迭或靶血管扭曲未能清楚显示。结论:与常规二维DSA相比,三维旋转DSA和三维图像重建能更精确地显示内脏动脉瘤的解剖信息,特别是对瘤颈的显示,从而可为介入诊断及治疗提供更精确的图像。

Objective：To evaluate the application of three-dimensional（3D）rotational digital subtraction angiography（DSA）and three-dimensional reconstruction technique in the interventional treatment of visceral artery aneurysm.Methods：A total of25 patients with visceral artery aneurysm,who underwent 3D rotational DSA and reconstruction before the interventional embolization treatment in the Department of Interventional Radiology,Zhongshan Hospital,Fudan University during Jan 2007 and Aug 2015,were selected.3D rotational DSA and reconstruction was performed by using Siemens Artis DTA or Philips Allura F20 DSA equipment,and the results were compared with that of conventional 2D DSA.Results：There were 8 hepatic artery aneurysms,10 splenic artery aneurysms,3 renal artery aneurysms,3 gastroduodenal artery aneurysms,and 1 inferior pancreaticoduodenal artery aneurysm among the 25 patients.The 3D rotational DSA procedures were successful in all patients,and the success rate was 100%.Anatomical morphology including the diameter,neck and cavity of aneurysm was exhaustively demonstrated.A total of 30 aneurysms were diagnosed by 3D rotational DSA among the 25 patients.Among the 30 aneuryms,only 27 aneurysms were confirmed by conventional 2D DSA,and the aneurysm necks of 15 aneurysms were not exhaustively demonstrated due to the anatomical overlapping of the large aneurysm cavity,or the vessel tortuosity.Conclusions： As compared to the conventional 2D DSA,the 3D rotational DSA and reconstruction can demonstrate anatomical information of visceral artery aneurysms more precisely,especially the aneurysm neck,so as to provide more precise images for the interventional diagnosis and treatment.