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旋转数字减影血管造影三维重建在脑血管疾病诊断 及鉴别中的应用价值
谢成仁
0
()
摘要:
目的 分析旋转数字减影血管造影(DSA)三维重建技术在脑血管疾病患者诊断与鉴别中 的应用价值。方法 选取 2016 年 1 月至 2018 年 1 月甘肃省武威市人民医院放射介入室 80 例疑似脑血 管疾病患者,均采取常规 DSA、旋转 DSA 三维重建技术进行检查,观察两种检查方式对患者脑血管病变 显示结果与脑血管疾病检出率,比较两种检查方式显示动脉瘤颈与载瘤动脉的关系。结果 常规 DSA 检查发现 59 例颅内动脉瘤(共 59 个动脉瘤),6 例大脑中动脉梗死,4 例动静脉畸形,11 例疑似脑血管病; 经旋转 DSA 三维重建技术检查发现 61 例颅内动脉瘤(包括 2 例多发动脉瘤,共 65 个动脉瘤,分布为:颈 内与后交通动脉 25 个,大脑中动脉 6 个,大脑前与前交通动脉 23 个,基底动脉 7 个,椎动脉 4 个),8 例大 脑中动脉梗死,6 例动静脉畸形(包括顶叶脑动静脉畸形 3 例,枕叶脑动静脉畸形 1 例,颞叶脑动静脉畸 形1例,小脑动静脉畸形1例),3例烟雾病(清晰显示血管异常),海绵窦瘘(清晰显示瘘口部位与回流静脉) 2例;旋转DSA三维重建对脑血管疾病检出率为100%,明显高于常规DSA的91.25%(χ2 =5.378,P<0.05); 对于动脉瘤颈与载瘤动脉的关系,旋转 DSA 三维重建显示清楚率为 100%,明显高于常规 DSA 显示清楚 率 49.15%(χ2 =43.040,P< 0.05)。结论 旋转 DSA 三维重建技术可以直观、立体并且清晰地显示脑部 病变血管情况,为脑血管疾病鉴别及临床诊治提供更准确、有效的指导。
关键词:  血管造影术, 数字减影  三维重建技术  脑血管疾病  诊断
DOI:10.3969/j.issn.1009-6574.2019.10.008
基金项目:
Application value of rotational DSA 3D reconstruction in diagnosis and identification of cerebrovascular diseases
Xie Chengren
()
Abstract:
Objective To analyze the application value of rotational digital subtraction angiography (DSA) three-dimensional (3D) reconstruction in the diagnosis and identification of cerebrovascular diseases. Methods From January 2016 to January 2018, a total of 80 patients with suspected cerebrovascular disease in the radiotherapy intervention room of our hospital were selected. All patients were examined with conventional DSA and rotational DSA 3D reconstruction technologies. The display results and diagnosis positive rate of cerebrovascular disease by the two examination methods were observed. The relationship between the aneurysmal neck and the parent artery displayed by the two methods was compared. Results Conventional DSA found 59 cases of intracranial aneurysms (59 aneurysms), including 6 cases of middle cerebral artery occlusion, 4 cases of arteriovenous malformations and 11 cases of suspected cerebrovascular diseases. The rotational DSA 3D reconstruction technology showed 61 cases of intracranial aneurysms including 2 cases of multiple aneurysms (65 aneurysms in total: 25 in intracervical and posterior communicating arteries, 6 in middle cerebral arteries, 23 in frontal and anterior communicating arteries, 7 in basilar arteries and 4 in vertebral arteries), 8 cases of middle cerebral artery occlusion, 6 cases of arteriovenous malformations (3 cases of parietal cerebral arteriovenous malformations, 1 case of occipital cerebral arteriovenous malformations, 1 case of temporal lobe cerebral arteriovenous malformations, 1 case of cerebellar arteriovenous malformations), 3 cases of moyamoya disease (clear abnormal blood vessels) and 2 cases of cavernous sinus fistula (clear fistula location and reflux veins). The diagnosis positive rate (100%) of cerebrovascular diseases by rotational DSA 3D reconstruction was significantly higher than that of conventional DSA (91.25%) (χ2 =5.378,P < 0.05). For the relationship between the aneurysmal neck and the parent artery, the clear display rate of DSA 3D reconstruction (100%) was significantly higher than that of conventional DSA (49.15%) (χ2 =43.040,P< 0.05). Conclusions Rotational DSA 3D reconstruction can visually and clearly display lesions in the brain, and provide more accurate and effective guidance for the identification and clinical diagnosis and treatment of cerebrovascular diseases.
Key words:  Angiography, digital subtraction  Three-dimensional reconstruction technique  Cerebrovascular disease  Diagnosis

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