三维数字减影血管造影与磁共振血管造影随访测量颅内动脉瘤栓塞残余的临床比较

Clinical comparison of three-dimensional digital subtraction angiography and magnetic resonance angiography in follow-up measurement of intracranial aneurysm embolization residue

目的探讨三维数字减影血管造影(3D-DSA)与磁共振血管造影(MRA)随访测量颅内动脉瘤栓塞残留的临床价值。方法选取2019年4月至2021年5月宜春新建医院收治的87例颅内动脉瘤栓塞患者作为研究对象,术后患者均常规行3D-DSA与MRA检查,并对患者进行6个月随访,比较不同检查方法在颅内动脉瘤栓塞残余中的测量效果,分析其诊断效能。结果3D-DSA检查显示:完全闭塞45例,颈部闭塞28例,残留动脉瘤14例;MRA检查显示:完全闭塞47例,颈部残留30例,残留动脉瘤10例,不同检查方法具有较高的一致性(Kappa=0.83、0.81)。3D-DSA检查显示2例(2.30%)发生并发症;MRA检查无并发症发生;3D-DSA检查获得良好的图像质量,1例患者检查过程中出现血管重叠;MRA检查图像清晰,4例伴有轻微干扰,未对结果产生影响。3D-DSA与MRA检查大脑前动脉(ACA)、大脑中动脉(MCA)及大脑后动脉(PCA)血管显示平均分支数量比较差异无统计意义。结论3D-DSA与MRA用于颅内动脉瘤栓塞残余测量中均能实现病灶分级,且二者联合检查诊断效能较高,可为临床诊疗提供影像学依据。

Objective To investigate the clinical value between three-dimensional digital subtraction angiography(3D-DSA)and magnetic reso-nance angiography(MRA)in the follow-up measurement of residual intracranial aneurysm embolization.Methods A total of 87 patients with intra-cranial aneurysm embolization from April 2019 to May 2021 in Xinjian Hospital,Yichun were selected as the research subjects,all patients under-went routine 3D-DSA and MRA examinations after surgery,and the patients were followed up for 6 months.Measurement effect in residual intracra-nial aneurysm embolization and analysis of its diagnostic performance.Results 3D-DSA examination showed 45 cases of complete occlusion,28 cases of neck occlusion,and 14 cases of residual aneurysm;MRA examination showed 47 cases of complete occlusion,30 cases of neck occlusion,and 10 cases of residual aneurysm.Different examination methods had high consistency(Kappa=0.83,0.81);2 cases(2.30%)developed complica-tions during 3D-DSA examination;MRA examination and no complications occurred;3D-DSA examination obtained good image quality,and 1 pa-tient was examined during the process,blood vessels overlapped;MRA examination images were clear,with slight interference in 4 cases,which did not affect the results.There were no statistically significant differences in the mean number of branches of anterior cerebral artery(ACA),middle ce-rebral artery(MCA),and posterior cerebral artery(PCA)vessels between 3D-DSA and MRA examination.Conclusion Both 3D-DSA and MRA can achieve lesion grading in the residual measurement of intracranial aneurysm embolization,and the combined examination of the two has high diag-nostic efficiency,which can provide imaging basis for clinical diagnosis and treatment.