颅内动脉瘤的放射诊断及介入治疗

目的：探讨血管内栓塞治疗颅内动脉瘤的适应证和效果。方法：对经血管内栓塞治疗及DSA复查的颅内动脉瘤患者68例的DSA影像、介入治疗进行回顾性分析。结果：本组动脉瘤直径2．0-20．0mm，病情按Hunt—Hess法分级：Ⅰ级14例，Ⅱ级42例，Ⅲ级10例，Ⅳ级2例。全部患者均经DSA全脑血管造影确诊后采取血管内栓塞治愈，并经DSA随诊见完全栓塞的动脉瘤无复发，2例栓塞90％的动脉瘤复发。结论：采用电解可脱式铂金螺旋圈（GDC）或微支架辅助GDC血管内栓塞是治疗颅内动脉瘤的一种微创、安全、有效的方法，DSA全脑血管造影是诊断颅内动脉瘤和检验动脉瘤栓塞效果的可靠手段，近期随诊结果表明采取血管内栓塞动脉瘤效果可靠。

Objective：To discuss the research of indication and results of endovascular embolization for intracranial aueurysms. Methods：The DSA images,interventional treatment of 68 cases that were undergone endovaseular embolization and counterchecked by DSA were an alyzed in retrospect. Results ：In the group the diameter of intracranial aneurysms ranged from 2.0mm to 20.0mm, and the condition of patients according to Hunt--Hess grade were：grade Ⅰ in 14ceses, grade Ⅱ in 42, grade Ⅲ in 10 and grade Ⅳin 2. All the cases were diagnosed by DSA and cured by endovascular embolization. In follow--up 2 case whose cavity of aneurysm was occluded with GDC by 90% and 2 case of pseudoaneurysm were recurred. Conclusion：Endovascular embolization with Guglielmi detachable coil（GDC）or GDC combining with stent is a minimal traumatic, secure and effective method of treatment for intracranial an eurysms. DSA is the credible means to diagnose intracranial aneurysms and to check up the result of embelization for intracranial aneurvsms. The treatment results are well in the near period follow--up.