三维DSA在后交通动脉起始部病变鉴别诊断中的价值

Value of 3D-digital subtraction angiography in the differential diagnosis of vascular lesion originating from the posterior communicating artery

目的探讨三维数字减影血管造影(3D-DSA)在鉴别诊断后交通动脉起始部动脉瘤与漏斗样扩张中的应用价值。方法回顾性分析47例后交通动脉起始部病变的患者资料,所有患者均进行常规二维数字减影血管造影(2D-DSA)与3D-DSA检查,由2名医生对检查结果进行判断分析。结果 2D-DSA发现真阳性动脉瘤26例,漏斗样扩张6例,3D-DSA发现动脉瘤33例,漏斗样扩张14例,2D-DSA与3D-DSA比较差异有统计学意义(χ2=19.03,P<0.05);对病变部位与周围血管间的关系显示中,两者比较差异有统计学意义(Z=-3.62,P<0.05)。结论三维DSA能清晰显示病变部位与毗邻血管之间的关系,在鉴别漏斗样扩张与动脉瘤的诊断中具有重要参考价值,值得推广。

Objective To explore the applicative value of three-dimensional digital subtraction angiography （3 D-DSA） in diagnosing aneurysm and infundibular dilation （ID）originating from the posterior communicating artery.Methods A total of 47 patients with vascular lesions originating from the posterior communicating artery were analyzed retrospec-tively.All patients had undergone angiography with both conventional DSA （2D-DSA）and 3D-DSA,and the results were analyzed by two doctors.Results Altogether 26 aneurysms and 6 IDs were found by 2 D-DSA,while 33 aneu-rysms and 14 IDs were detected by 3D-DSA,with a statistical significance between the detection rates （χ2 =19.03,P〈0.05）.There was a statistical difference in displaying the relationship between the lesion and adjacent vessels （Z=-3.62,P〈0.05）.Conclusion The 3D-DSA can clearly display the relationship between the lesion and adjacent vessels,which is important in the differential diagnosis of ID and aneurysm,thus it is worthy of spreading.