三维数字减影血管造影在脑动脉瘤治疗和随访中的应用

Application of three dimensional digital subrtaction angiography in endovascular treatment and follow up for intracranial aneurysms

目的 探讨三维数字减影血管造影 (3DDSA)在脑动脉瘤血管内栓塞治疗及随访中的价值。方法 对 4 9例疑诊或确诊动脉瘤的病例 ,术前、栓塞术中行 3DDSA检查 ,其中 10例作 3DDSA随访。结果 4 9例中经 3DDSA证实共检出 4 7例 5 3个动脉瘤 ,3DDSA对动脉瘤形状、瘤颈及瘤颈与载瘤血管关系能更好地显示 ,准确判断动脉瘤血管内栓塞的可行性 ,并为栓塞治疗提供最佳工作角度。 12例病人因 3DDSA检查而改变了原来的治疗方法。3DDSA尚可准确判断动脉瘤的栓塞程度及有无复发。结论 3DDSA可提高颅内动脉瘤血管内栓塞的安全性 ,并有助于随访研究。

Objective To evaluate the role of three dimensional digital subtraction angiography (3D DSA) in endovascular treatment and follow up for intracranial aneurysms. Methods 3D DSA before and during endovascular embolization was performed in 49 cases with suspected aneurysms, in which 10 case were followed up by 3D DSA. Results 47 patients with 53 aneurysms were identified with 3D DSA. 3D DSA could clearly depict the shape and neck of the aneurysm and its relation with the parent artery, which helped to correctly judge the feasibility of endovascular treatment and provide the best angle of embolization. Therapeutic methods were changed in 12 cases because of 3D DSA findings. 3D DSA could correctly judge the state of embolization and the recurrence of the aneurysm after embolization. Conclusions 3D DSA can improve the secure embolization of intracranial aneurysms, and do good to the follow up of the aneurysms.