颅内动脉瘤DSA检查的显示满意程度分析和最佳体位选择

Analysis on the satisfactory degrees of revealing intracranial aneurysms with DSA and the selection of optimal postures

目的探讨颅内各部位动脉瘤在不同体位的显示满意程度,以便优化体位设计,增加DSA检查对颅内动脉瘤的显示满意度,从而提高检出率。方法197例全脑血管造影中椎动脉造影时常规摄取正、侧位图像,必要时加摄特殊斜位,颈内(颈总)动脉造影时,常规摄取正、侧、斜位1,必要时加摄特殊斜位,分析所有检出动脉瘤的DSA图像资料,评价各部位动脉瘤在不同体位上显示满意程度的差异。结果197例全脑血管造影共检出颅内动脉瘤85例94个,阳性率为43.15%,后交通动脉瘤最多,共51个,占54.3%。后交通动脉瘤侧位均显示良好,占100%,而前交通动脉瘤斜位1均显示良好,占100%。结论合理选择不同角度的斜位,能更清晰地显示动脉瘤的结构及与周围血管的毗邻关系,提高颅内动脉瘤的显示满意程度和检出率。

Objective To evaluate the satisfactory degrees of revealing intracranial aneurysms with DSA on different postures so as to design the optimal posture and to improve the diagnostic accuracy. Methods Among 197 cases of cerebral angiography, both postero - anterior and lateral images were acquired during vertebral artery angiography, special oblique positions were added if necessary, while postero -anterior, lateral and oblique position I images were acquired during routinely internal carotid（common carotid） artery angiography, special oblique positions were added if necessary. DSA images obtained from all patients with intracranial aneuryms were analyzed and the differences of saltisfactory degrees on different postures for revealing aneurysms were evaluated. Results 94 intracranial aneurysms of 85 cases were found in 197 patients who underwent cerebal angiography. Positive rate was 43. 15 %. Posterior communicating aneurysms were found in 51（54.3 % ） cases, on lateral position these aneurysms were best revealed（revealing rate, 100 % ） . While all anterior communicating aneurysms were best revealed on oblique positon I（revealing rate, 100 % ） . Conclusion The reasonable selection of oblique position with different angles can more clearly reveal the aneurysmal structure and its relation to neighbor vessels i. e. can improve the satisfactory degree of revealing aneurysms or detect rate.