旋转DSA诊断颅内动脉瘤的价值

Rotational DSA assessment of intracranial aneurysms

目的 研究旋转DSA对颅内动脉瘤的诊断价值。方法 使用荷兰PHILIPS INTEGRISV 30 0 0型DSA系统 ,对 2 0例疑有颅内动脉瘤的蛛网膜下腔出血患者作旋转DSA检查 ,并与常规DSA检查比较 ,得到一系列关于动脉瘤的定位 ,动脉瘤颈的清晰度及血管分支解剖的图象。结果 旋转DSA诊断颅内动脉瘤的 2 0例患者 ,常规DSA检查发现 18例动脉瘤 ,其中 6例 (6 / 18)动脉瘤的载瘤动脉及周围血管解剖关系显示不清 ,7例 (7/ 18)动脉瘤的颈部显示不清。加摄旋转DSA检查后 ,动脉瘤的全貌 ,瘤颈的位置与结构及周围血管分支的解剖关系清晰显示。结论 旋转DSA可更好、更清晰的显示动脉瘤的颈部及其周围的血管解剖结构 ,从而提高了动脉瘤的血管造影诊断价值 ,为手术提供更为准确的参考价值。

Objective To compare rotational DSA with routine DSA in the assessment of intracranial aneurysms. Methods Conventional anteroposterior, lateral and oblique views of DSA and rotational DSA were respectively performed in 20 patients suspected of intracranial aneurysms in subarachnoid hemorrhage using DSA (Philips Integris V 3000DSA system). Images were compared for localization of the aneurysm, shape of the aneurysmal neck and vascular branch anatomy. Results Among 20 patients, only 18 intracranial aueurysms were found by convertional DSA and the other two were only by the rotational DSA. Furthermore, conventional DSA examination could not clarify the relationships of 6 (6/18) aneruysms with their parent arteries and with the vascular branch anatomy including the aneurysmal neck could not be clarified in 7 (7/18) patients. However, shape of the aneurysms and visibility of the aneurysmal neck could be clarified after using the rotational DSA, and meanwhile, vascular anatomy can be indentified with the rotational DSA. Conclusion Rotational DSA often allows better visibility of vascular anatomy and aneurysmal neck compared with conventional DSA, offering more important information for operation.