三维DSA在颅内动脉瘤中的应用

Application of 3D DSA in Intracranial Aneurysms

目的探讨三维数字减影血管造影(3D DSA)在颅内动脉瘤中的应用价值。方法使用GE Innova 3100平板血管造影机对40例疑似颅内动脉瘤患者行双侧颈内、外动脉和双侧椎动脉正、侧位2D DSA,进一步对感兴趣血管行3D DSA,通过容积再现(VR)进行颅内血管重建。结果 3D DSA检出39例动脉瘤患者,47枚动脉瘤,2D DSA检出31例动脉瘤患者,35枚动脉瘤,二者检出动脉瘤的长、短径无统计学差异(P>0.05),图像质量有统计学差异(P<0.05)。2D DSA出现假阳性动脉瘤3枚,假阴性动脉瘤15枚,评估颅内动脉瘤的灵敏度为78.9%,特异性为85.2%;3D DSA没有出现假阳性、假阴性动脉瘤,评估颅内动脉瘤的灵敏度为100%,特异性为100%。在动脉瘤形态、瘤颈尺寸及与相邻血管间的关系的显示上,3D DSA明显优于2D DSA。结论 3D DSA作为脑动脉造影中2D DSA的进一步补充,对颅内动脉瘤的诊断与治疗具有重要价值。

Objective To study the clinical value of three dimensional digital subtraction angiography(3D DSA) in intracranial aneurysms.Methods Using GE Innova 3100 flat panel angiography sanner,40 patients with suspected intracranial aneurysms,orthotopic and lateral 2D DSA were underwent on them in bilateral carotid artery and bilateral vertebral artery,further to the interest blood vessel,3D DSA were underwent on them,acquiring intracranial vessels through volume rendering(VR) reconstruction.Results 39 patients with aneurysms,47 aneurysms were detected by 3D DSA,31 patients with aneurysms,35 aneurysms were detected by 2D DSA,the long and short diameter of aneurysms were detected by 3D DSA and 2D DSA have no statistical difference(P>0.05),but the image quality have significantly difference(P<0.05).3 false positive aneurysms,and 15 false negative aneurysms by 2D DSA,the sensitivity of 2D DSA to assess intracranial aneurysms was 78.9%,specificity was 85.2%;no false positive and false negative aneurysms by 3D DSA,the sensitivity of 3D DSA to assess intracranial aneurysms was 100%,specificity was 100%.In the aneurysm morphology,aneurysm neck size and the dispalyment of relationship between blood vessels and adjacent,3D DSA is superior to 2D DSA.Conclusion 3D DSA as a further supplement to 2D DSA in cerebral angiography,have great diagnosis and treatment value to intracranial aneurysms.