三维数字减影血管造影在颅内动脉瘤诊疗中的应用价值

Three-dimensional digital subtraction angiography for diagnosis and treatment of intracranial aneurysms

目的:探讨3D-DSA在颅内动脉瘤诊断和治疗中的应用价值。方法:对蛛网膜下腔出血患者常规行DSA检查,发现病变或可疑病变后行3D-DSA检查。结果:26例颅内动脉瘤中检出动脉瘤31枚,其中后交通9枚,C1段3枚,C2段5枚,C3段3枚,前交通6枚,大脑中3枚,椎动脉动2枚。3例2D-DSA未见病变3D-DSA确诊,5例因血管重叠3D-DSA排除了动脉瘤。6枚GDC栓塞,5枚手术夹闭,2枚颈内动脉可脱性球囊封阻术。结论:3D-DSA极大提高了脑血管造影检查的准确性和可靠性,为动脉瘤的介入治疗和手术夹闭提供了可靠保障,在临床诊疗中具有很高的应用价值。

Objective：To investigate the application value of three - dimensional digital subtraction angiography （3D - DSA） in the diagnosis and treatment of intracranial aneurysms. Methods： The patients with subarachnoid hemorrhage were routinely examined by DSA. Those with positive changes were further examined by 3D -DSA. Results： Thirty -one lesions of intracranial aneurysms were found in 26 patients by 3D - DSA. Nine aneurysms were located at posterior communicating arteries and 6 aneurysms at anterior communicating arteries. Three aneurysms were located in C1, 5 in C2, and 3 in C3 segments. Two aneurysms were located at vertebral artery. Three aneurysms not discovered by 2D - DSA were finally diagnosed by 3D - DSA. Five suspected lesions during conventional DSA were ruled out by 3D - DSA because of overlapping blood vessels. detachable coil （GDC） and 4 were occluded by Six aneurysms were treated by embolism with Guglielmi surgery. The detachable balloon was used in one case. Conclusion： 3D -DSA is valuable in the diagnosis and treatment of intracranial aneurysms. It improves the precision and reliability of brain angiography greatly and provides strong support for interventional and surgical therapy.