CAJ | 학술논문

目的报告一个描述颅内动脉瘤弧形瘤颈侵及、占据或涉及(以下称侵及)载瘤动脉圆周情况的新概念——“颈宽角”,并探讨其指导动脉瘤血管内栓塞治疗的意义.方法在载瘤动脉横断面像上,将载瘤动脉壁所构成的图形概括为圆；在此圆上,将动脉瘤瘤颈所侵及的载瘤动脉壁所对应的圆心角定义为颈宽角.回顾近期采用支架内球囊再塑形技术辅助微弹簧圈栓塞治疗的8例宽颈动脉瘤的颈宽角估测结果,结合其影像、栓塞情况,分析颈宽角概念的科学性、必要性、可行性和实用性.结果 8例动脉瘤的颈宽角均大于90°,其角度区间为:90°～ 135°有4例,136°～180°有2例,181°～ 225°有l例,226°～270°有1例.8例动脉瘤均采用支架内球囊再塑形技术辅助微弹簧圈而成功栓塞,填入的微弹簧圈边缘在瘤颈部呈弧形,相应的载瘤动脉壁被重建,瘤颈部栓塞满意.结论颈宽角概念能够表达颅内动脉瘤,特别是一些无颈或梭形动脉瘤弧形瘤颈侵及载瘤动脉的情况,有助于其血管内治疗方法的选择.
목적 보고일개묘술로내동맥류호형류경침급、점거혹섭급(이하칭침급)재류동맥원주정황적신개념——“경관각”,병탐토기지도동맥류혈관내전새치료적의의.방법 재재류동맥횡단면상상,장재류동맥벽소구성적도형개괄위원；재차원상,장동맥류류경소침급적재류동맥벽소대응적원심각정의위경관각.회고근기채용지가내구낭재소형기술보조미탄황권전새치료적8례관경동맥류적경관각고측결과,결합기영상、전새정황,분석경관각개념적과학성、필요성、가행성화실용성.결과 8례동맥류적경관각균대우90°,기각도구간위:90°～ 135°유4례,136°～180°유2례,181°～ 225°유l례,226°～270°유1례.8례동맥류균채용지가내구낭재소형기술보조미탄황권이성공전새,전입적미탄황권변연재류경부정호형,상응적재류동맥벽피중건,류경부전새만의.결론 경관각개념능구표체로내동맥류,특별시일사무경혹사형동맥류호형류경침급재류동맥적정황,유조우기혈관내치료방법적선택.
Objective To describe a geometric parameter for delineating the extent to which the parent artery is incorporated by the aneurysm neck,and to investigate the application of this parameter in endovascular treatment of intracranial aneurysm.Method In the 2D cross - section image obtained from the digital subtract angiography which containing simultaneously the aneurysm neck and the parent artery,the vessel lumen boundary of the parent artery is idealized to be a circle and two boundary points were thus determined in this circle where the aneurysm neck incorporating with the parent artery.The central angle formed by these two points and the circle center was defined as the arcuate neck angle,a new geometric parameter.Eight intracranial aneurysms embolized by utilizing the balloon - in - stent technique were reviewed for their measurement results of the arcuate neck angle,as well as their imaging and endovascular therapeutic data.The feasibility and practicability of utilizing this geometric parameter in endovascular treatment was investigated.Results The arcuate neck angle was more than 90° in all eight aneurysms.The measurement detail was as the following:more than 90° and less than or egual to 135° in four intracranial aneurysms,more than 135° and less than or egual to 180° in two,more than 180° and less than or egual to 225° in one,more than 225° and less than or egual to 270° in one aneurysm.These aneurysms were all successfully coil embolized.The margin of coil mass at the aneurysm neck appeared to be an arc,where the vessel wall of parent artery was reconstructed,and the aneurysm neck was also satisfactorily occluded for all cases.Conclusions The arcuate neck angle of intracranial aneurysms may approximately represent the extent to which the parent artery is incorporated by the aneurysm neck,especially for some fusiform ones or those without neck.It may benefit the optimization of endovascular therapy for intracranial aneurysms.