荧光造影和B超在脑浅表动静脉畸形手术中的联合应用

Intraoperative integration of B-ultrasound and indocyanine green angiography in the surgery of superficial cerebral arteriovenous malformations

目的 探讨B超和吲哚菁绿血管造影（ICGA）在脑浅表动静脉畸形（AVMs）手术中的应用价值.方法 回顾性分析自2009年1月至12月北京天坛医院神经外科血管组联合应用B超和ICGA辅助切除的16例脑浅表AVMs患者临床资料,同时分析2种术中辅助技术对AVMs定位、边界确定及血管类型鉴别的作用.结果 术中联合应用ICGA和B超能有效帮助定位AVMs,确定其边界,帮助辨认供血动脉和引流静脉.16例脑浅表AVMs患者共行开颅手术16次,均全切病灶,手术后经DSA证实AVMs无残留.结论 脑浅表AVMs手术中联合应用ICGA和B超能有效帮助准确切除病灶,判断有无畸形残留,具有较高的临床应用价值.

Objective To evaluate the surgical effect of intraoperative combined use of B-ultrasound and indocyanine green angiography （ICGA） in the surgery of superficial cerebral arteriovenous malformations （AVMs）. Methods Sixteen patients with superficial cerebral AVMs,admitted to our hospital from January 2009 to December 2009, were performed surgery with the help of intraoperative B-ultrasound and ICGA; the clinical data of these patients were retrospectively collected.The ability of intraoperative B-ultrasound and ICGA in distinguishing AVMs＇ vessels （draining veins,feeding and nidal arteries） from each other and from normal vessel was both evaluated.Results The combination of B-ultrasound and ICGA allowed accurate and real-time localization of the AVMs＇ nidus,helped to define the boundary and identify the draining veins and feeding arteries. Total lesion removal was achieved by 16 successful surgeries in 16 patients, which was confirmed by postoperative DSA.Conclusion The combination of B-ultrasound and ICGA in the surgery of superficial cerebral arteriovenous malformations allows accurate and real-time localization of the AVMs＇ indus and helps to assess the completeness of lesion removal, indicating its value in the surgery of superficial cerebral AVMs.