脑脊髓血管造影4D成像技术及其在脑脊髓血管病中的应用

Application of four-dimensional cerebrospinal angiography techniques to diagnosis and treatment of cerebrospinal vascular diseases

目的 探讨脑脊髓血管造影4D成像技术及其在脑脊髓血管病诊治中的应用价值。方法 回顾性分析2018年1月至2022年1月收治的57例脑脊髓血管病的临床资料。使用双平板DSA机行2D-DSA、3D-DSA、4D-DSA数据采集,再将原始成像数据传输到后处理工作站,利用成像软件重建动态全循环立体影像。结果 57例中,脑动静脉畸形37例,硬脑膜动静脉瘘10例,硬脊膜动静脉瘘5例,脊髓髓周动静脉瘘2例,脊髓动静脉畸形2例,硬脊膜外动静脉瘘1例。4D-DSA均做出正确诊断,指导显微手术或血管内治疗,取得满意效果。结论 4D-DSA对影像进行动态分析,提供更精准的影像,丰富了脑脊髓血管病诊断金标准(DSA含金量),对脑脊髓血管病的精准治疗有指导价值。

Objective To explore the clinical value of 4D-DSA techniques in the dignosis and treatment of cerebrospinal vascular diseases. Methods The clinical data of 57 patients with cerebrospinal vascular disease who were admitted to our hospital from January2018 to January 2022 were retrospectively analyzed. The 2D-DSA, 3D-DSA, and 4D-DSA data were collected using a biplane angiography system. The 4D-DSA data were inputed into a post-processing workstation, and then were reconstructed into dynamic fullcirculation stereoscopic images(4D) using the 4D-DSA reconstruction software. Results Of 57 patients, 37 patients were cerebral arteriovenous malformations, 10 dural arteriovenous fistulas, 5 spinal dural arteriovenous fistulas, 2 spinal perimedullary arteriovenous fistulas, 2 spinal arteriovenous malformations, and 1 epidural arteriovenous fistula. All the patients were correctly diagnosed by 4D-DSA, which successfully guided the microsurgery or endovascular treatment for the patients and obtained good outcomes. Conclusions 4D-DSA can dynamically analyze their angiography images and provide more accurate angiography images, which has guiding values in the clinical precision treatment for the patients with cerebrospinal vascular disease.