VasoCT对支架辅助弹簧圈栓塞颅内动脉瘤的效果评估

Application of VasoCT in stent-assisted coil aneurysm embolization

目的探索VasoCT支架显影技术在支架辅助弹簧圈栓塞颅内动脉瘤术中的应用。方法连续纳入2013年12月至2014年11月于武警总医院行支架辅助弹簧圈栓塞颅内动脉瘤的20例患者(23个动脉瘤),术毕均行VasoCT扫描,分别对所得图像行支架重建,在XpertCT模式下以容积成像及最大密度投影两种方式观察所得图像,并按支架显影清晰度将所得图像分为非常清晰、欠清晰、不清晰。结果 22个由支架辅助栓塞的动脉瘤中,16个完全栓塞,6个不全栓塞,所有支架完全撑开并释放至预定位置;其中11个动脉瘤支架显影清晰,9个动脉瘤显影欠清晰,2个动脉瘤显影不清晰。结论 VasoCT可用于支架辅助动脉瘤栓塞术的效果评估,能够清晰显示支架精微结构、位置、与血管壁的关系及支架与弹簧圈的关系。支架显影清晰度与填塞弹簧圈直径相关,同时受金属伪影投射方向及填塞弹簧圈致密程度影响。

Objective To explore the application of Vaso CT,a stent imaging technique,in stent-assisted coil aneurysm embolization. Methods Twenty consecutive patients with 23 intracranial aneurysms were treated with stent-assisted aneurysm embolization in the General Hospital of Armed Police Forces from December 2013 to November 2014 were enrolled. The patients performed Vaso CT scan immediately after procedure. Then all the available images were used for stent-optimized reconstruction respectively. Under the Xpert CT mode,the available images were observed with both volume imaging and maximum intensity projection. The available images were analyzed and they were divided into very clear,less clear,and not clear according to the stent developing clarity. Results Of the 22 aneurysms treated with stent-assisted embolization,16 were occluded completely,6 were occluded partially. All the stents were expanded completely and were released to the expected locations; 11 aneurysm stents developed clearly,9 developed less clearly,and2 did not develop clearly. Conclusion Vaso CT can be used in the stent-assisted aneurysm embolization. It can clearly reveal the microscopic structure of the stents,location,relationship with the artery wall,and relationship between stents and coils. The clarity of stent development is associated with the diameters of the packed coils,and the stents are also affected by the metal artifacts projecting direction and the dense degree of the packing coils.