CAJ | 학술논문

目的：探讨颅内动脉瘤介入栓塞术中，透视三维路径图指引技术的应用方法和临床价值。方法2010年8月～2012年6月在我院使用同一台DSA机实施单个颅内动脉瘤栓塞术的患者61例，分A、B两组。A组25例患者采用常规二维路径图指引技术进行颅内动脉瘤介入栓塞，B组36例患者均在透视三维路径图的实时指引下进行介入栓塞操作。分别记录A、B两组的栓塞治疗时间、总体透视时间、总体透视入射表面剂量、动脉瘤栓塞程度等数据，进行对比分析。由有经验的做颅内动脉瘤栓塞的手术医师分别对两种指引技术进行主观评分并做对比分析。结果 A、B两组在栓塞治疗时间、总体透视时间、总体透视入射表面剂量均有显著性差异，B组比A组分别减少了23%、16%、30%。A、B两组在动脉瘤栓塞程度上不具有显著性差异（P＝0.990）；两种指引方法在手术医师主观评价上具有显著性差异（P＝0.000），透视三维路径图指引评分高于常规二维路径图指引。结论使用透视三维路径图指引技术进行颅内动脉瘤的介入栓塞，指引图像清晰、操作简便，可以提高手术医师操作信心和效率，从而提高手术安全性、缩短手术时间、减少患者和医生的X射线辐射，具有很高的临床应用价值。
목적：탐토로내동맥류개입전새술중，투시삼유로경도지인기술적응용방법화림상개치。방법2010년8월～2012년6월재아원사용동일태DSA궤실시단개로내동맥류전새술적환자61례，분A、B량조。A조25례환자채용상규이유로경도지인기술진행로내동맥류개입전새，B조36례환자균재투시삼유로경도적실시지인하진행개입전새조작。분별기록A、B량조적전새치료시간、총체투시시간、총체투시입사표면제량、동맥류전새정도등수거，진행대비분석。유유경험적주로내동맥류전새적수술의사분별대량충지인기술진행주관평분병주대비분석。결과 A、B량조재전새치료시간、총체투시시간、총체투시입사표면제량균유현저성차이，B조비A조분별감소료23%、16%、30%。A、B량조재동맥류전새정도상불구유현저성차이（P＝0.990）；량충지인방법재수술의사주관평개상구유현저성차이（P＝0.000），투시삼유로경도지인평분고우상규이유로경도지인。결론사용투시삼유로경도지인기술진행로내동맥류적개입전새，지인도상청석、조작간편，가이제고수술의사조작신심화효솔，종이제고수술안전성、축단수술시간、감소환자화의생적X사선복사，구유흔고적림상응용개치。
Objective To explore the value of 3D fluoroscopic roadmap guiding technique in embolization of intracranial aneurysms.Methods 61 patients underwent embolization treatment of solitary intracranial aneurysms from August 2010 to June 2012.The patients were randomly divided into a group(25)using conventional 2D and a group(36)using 3D fluoroscopic roadmap guiding techniques.The duration of the entire procedure and fluoroscopy,entrance surface dose(ESD),and degree of aneurysm embolization were recorded.The two techniques were subjectively scored by an experienced interventional neuroradiologist and compared.Results The duration of the procedure and fluoroscopy time as well as the ESD were significantly(P<0.05)reduced by 23%,16%and 30%,respectively with the 3D fluoroscopic roadmap.The difference of aneurysm embolization was not significant (P=0.99).The score of the 3D fluoroscopic roadmap was significantly higher than that of conventional 2D roadmap(P=0). Conclusions 3D fluoroscopic roadmap guiding technique is convenient and safe with high image quality and reduced procedure time and radiation exposure.