3D-slicer软件在颅内动脉瘤诊断中的应用价值及与DSA的对比研究

Application value of 3D-slicer software compared with DSA in the diagnosis of intracranial aneurysms

目的比较3D-slicer软件与数字减影血管造影(DSA)在颅内动脉瘤诊断中的应用价值。方法回顾性分析2016年9月至2018年2月郑州大学第一附属医院收治的98例疑似动脉瘤患者的临床资料,所有患者均行CT血管造影检查和DSA检查,以DSA检查结果及测量数据为金标准,将全部患者CT血管造影原始数据导入3D-slicer软件中进行体积渲染、减影、分割,对颅内血管进行三维重建以清晰显示动脉瘤,并精确测量各项参数,分析3D-slicer软件在颅内动脉瘤诊断中的临床价值。结果98例患者DSA共检测出50例患者共57个动脉瘤,6例患者为多发动脉瘤。3D-slicer处理后48例患者共检测出53个动脉瘤,对于每例患者诊断的敏感度为96.0%、特异度为97.9%。与DSA对照组比较,3D-slicer处理测量的动脉瘤平均瘤颈及平均最大直径测量结果差异未见统计学意义(P>0.05)。结论3D-slicer软件进行术前虚拟重建,可以取得大量立体解剖信息,有助于神经外科医生独立快速诊断,并为制定个体化手术方案提供帮助。

Objective To compare the application value of 3D-slicer software and digital subtraction angiography (DSA) in the diagnosis of intracranial aneurysms. Methods The clinical data of 98 patients with suspected aneurysms admitted to the First Affiliated Hospital of Zhengzhou University from September 2016 to February 2018 were retrospectively analyzed. All patients were detected by computed tomography angiography (CTA) and DSA, with DSA examination results as the gold standard. The original data of all patients were imported into 3D-slicer software for volume rendering, substraction and segment editor. 3D reconstruction of intracranial vessels was conducted to clearly display aneurysms with parameters measured accurately. Clinical significance of 3D-slicer software in diagnosis of intracranial aneurysms was analyzed. Results Among the 98 cases, 57 intracranial aneurysms were detected by DSA from 50 patients, including 6 patients with multiple aneurysms. Fifty-three aneurysms were checked out by 3D-slicer from 48 patients. The sensitivity and specificity on each patient was 96.0% and 97.9%, respectively. Detection results of the mean maximum tumor diameter and the mean aneurysm neck diameter determined by 3D-slicer were not significantly different from indexes determined by DSA (P>0.05). Conclusions Through the pre-operation virtual reconstruction, 3D-slicer can offer comprehensive information about the anatomy to help the neurosurgeon make diagnosis quickly by themselves and make individualized surgical plan.