平板DSA三维容积重建技术在出血性脑血管病变诊断及治疗中的应用价值

Effects of the Panel DSA 3D-VRT in the Diagnosis and Treatment of Cerebrovascular Hemorrhage

目的探讨平板数字减影血管造影(DSA)三维容积重建(3D-VRT)结合路径图技术在出血性脑血管病变诊断及治疗中的应用价值。方法选择134例出血性脑血管病变患者进行DSA造影及血管内介入治疗,治疗过程分两组,1组85例行旋转DSA造影且3D-VRT及二维DSA(2D-DSA)检查并结合路径图(roadmap)技术治疗,分析动脉瘤、动、静脉畸形(AVM)、颈内动脉海绵窦瘘(CCF)在平板DSA 3D-VRT上的影像表现并与2D-DSA比较,2组49例全部行2D-DSA造影在roadmap技术辅助下行介入治疗,并与1组治疗过程进行比较。结果诊断上,与2D-DSA相比,3D-VRT在动脉瘤的检出率和瘤颈的判别上差异有统计学意义(P<0.01);对AVM的供血动脉、畸形团构筑显示差异有统计学意义(P<0.01);对CCF瘘口的位置、形态显示及瘘口大小的判别差异有统计学意义(P<0.01)。治疗时,3D-DSA联合roadmap技术在与2D-DSA联合roadmap技术比较中,在roadmap的成像次数、造影剂的剂量和X线辐射剂量差异均有统计学意义(P<0.01)。结论 3D-VRT结合roadmap技术在出血性脑血管病的影像诊断及介入治疗中具有重要的应用价值。

Objective To discuss the effects of combination of the panel DSA （Digital Subtraction Angiography） 3D-VRT （Three Dimensional Volume-rendering Technique） and the roadmap （Path Diagram） technology in diagnosis and treatment of cerebrovascular hemorrhage. Methods A total of 134 patients with cerebrovascular hemorrhage were randomly divided into two groups： Group A （85 cases） and Group B （49 case）. After being examined with RDSA （Rotational Digital Subtraction Angiography）, 3D-VRT as well as 2D-DSA （Two Dimensional Digital Subtraction Angiography）, Group A received intravascular interventional treatment under the assistance of the roadmap technology to identify the DSA 3D-VRT features of aneurysm, AVM （Arteriovenous Malformation） and CCF （Carotid- Cavernous Fistulas） and compare them with 2D-DSA features. While, Group B was examined with 2D-DSA and treated with roadmap-assisted interventional therapies for comparison of the treatment process with Group A. Results In comparison of 3D-VRT with 2D-DSA in the aspects of diagnostic results, statistically significant differences existed in diagnosing aneurysm and recognizing aneurysmal necks （P〈0.01）, displaying blood-supplying arteries and malformation morphology ofAVW （P〈0.01）, identifying the location, morphology and size of CCF （P〈0.01）. As for comparisons between 3D-VRT and 2D-DSA applied during the treatment process, there was of statistical significance in the aspects of roadmap imaging times, contrast dose and X-ray radiation dose （P〈0.01）. Gonclusion 3D-VRT combined with the roadmap technology has great application value in the imaging diagnosis and interventional treatment of cerebrovascular hemorrhage.