3D-数字减影血管造影联合Innova-计算机断层扫描功能在颅内支架辅助动脉瘤弹簧圈栓塞术后复查中的应用

Application of 3D-digital subtraction angiography combined with Innova-computed tomography function in postoperative review of intracranial stent-assisted coil embolization of aneurysms

目的探讨颅内支架辅助动脉瘤弹簧圈栓塞术复查时3D-数字减影血管造影(DSA)联合Innova-计算机断层扫描(CT)的影像学表现对患者术后评估的影响。方法收集2021年1月至2022年12月安徽医科大学第三临床学院/合肥市第三人民医院收治的104例颅内支架辅助动脉瘤弹簧圈栓塞术后复查患者的临床资料,所有患者均行3D-DSA和Innova-CT扫描,由两名神经介入医师对重建后的图像从术后颅内动脉瘤栓塞程度、支架打开情况及重建图像的质量方面进行评估。结果104例颅内支架辅助动脉瘤弹簧圈栓塞术后复查患者均通过3D-DSA联合Innova-CT检查获得了精确、全面的术后评估。两名神经介入医师对术后颅内动脉瘤栓塞程度、颅内动脉瘤支架打开情况的评估分级比较,差异均有统计学意义(P﹤0.05)。Innova-CT图像支架金属丝显影清晰,弹簧圈金属伪影不明显,图像质量显著提高。3D-DSA和Innova-CT的图像质量比较,差异有统计学意义(P﹤0.05)。Kappa检验结果显示,两名神经介入医师评估术后颅内动脉瘤栓塞程度、支架打开情况、铂金标记点、镍钛金属丝、弹簧圈金属伪影的Kappa值均≥0.75,具有较高的一致性。结论Innova-CT在颅内支架辅助动脉瘤弹簧圈栓塞术后复查中,特别是在支架打开情况的显示方面具有独特的优势,可作为3D-DSA的补充检查方式,使检查更加完善,对颅内支架辅助动脉瘤弹簧圈栓塞术后复查情况的评估具有指导作用。

Objective To investigate the effect of 3D-digital subtraction angiography(DSA)combined with Innovacomputed tomography(CT)on postoperative evaluation of intracranial stent-assisted coil embolization of aneurysms.Method The clinical data of 104 patients admitted to the Third Clinical College of Hefei of Anhui Medical University/the Third People's Hospital of Hefei from January 2021 to December 2022 were collected,who underwent follow-up examinations after intracranial stent-assisted aneurysm coil embolization.All patients underwent 3D-DSA and Innova-CT scanning.The postoperative embolization degree of intracranial aneurysm,stent opening,as well as the image quality of the reconstructed images were evaluated by two neurointerventional physicians.Result The reconstructed images of 104 patients who underwent follow-up examinations after intracranial stent-assisted aneurysm coil embolization were analyzed comprehensively and the accurate postoperative evaluation was obtained.There were statistically significant differences in the postoperative embolization degree and stent opening of intracranial aneurysm evaluated by two neurointerventional physicians(P<0.05).The innova-CT image support wire developed clearly,while the spring ring metal artifact was not obvious,and the image quality was significantly improved.The comparison of image quality between 3D-DSA and Innova CT showed statistically significant difference(P<0.05).The Kappa test results showed that the Kappa values of two neurointerventional physicians evaluating the postoperative intracranial aneurysm embolization degree,stent opening,platinum marker points,nickel titanium metal wires,and coil metal artifacts were all≥0.75,indicating high consistency.Conclusion Innova-CT has unique advantages in intracranial stent-assisted aneurysm coil embolization,especially the display of stent opening,which is a supplementary examination for 3D-DSA,making the examination more perfect,and playing a guiding role in the evaluation of intracranial stent-assisted coil embolization of aneurysms.