CAJ | 학술논문

目的：评价三维数字减影血管造影（DSA）容积重建在颅内小动脉瘤的诊断价值。方法对129例可疑颅内动脉瘤患者在行弹簧圈栓塞前进行二维DSA和三维容积重建-数字减影血管造影（VR-DSA）检查。结果三维VR-DSA显示105例患者有123枚动脉瘤，24例无动脉瘤。3例患者检测到3枚动脉瘤；12例患者同时检测到2枚动脉瘤；90例患者检测到1枚动脉瘤。所有的动脉瘤的形态在三维VR-DSA上均可清晰显示。二维DSA显示98例患者有110枚动脉瘤，31例无动脉瘤。1例患者检测到3枚动脉瘤；10例患者同时检测到2枚动脉瘤；87例患者检测到1枚动脉瘤。仅65例患者的动脉瘤的形态在二维DSA上可清晰显示。三维VR-DSA发现13例额外动脉瘤，位于颈内动脉（10例，77％），位于前交通动脉（3例，33％）。大脑中动脉与椎基底动脉未发现额外动脉瘤。结论三维容积DSA不仅能清晰显示动脉瘤的大小及形态，而且能检测出二维DSA未检出的动脉瘤，特别是微小动脉瘤。
목적：평개삼유수자감영혈관조영（DSA）용적중건재로내소동맥류적진단개치。방법대129례가의로내동맥류환자재행탄황권전새전진행이유DSA화삼유용적중건-수자감영혈관조영（VR-DSA）검사。결과삼유VR-DSA현시105례환자유123매동맥류，24례무동맥류。3례환자검측도3매동맥류；12례환자동시검측도2매동맥류；90례환자검측도1매동맥류。소유적동맥류적형태재삼유VR-DSA상균가청석현시。이유DSA현시98례환자유110매동맥류，31례무동맥류。1례환자검측도3매동맥류；10례환자동시검측도2매동맥류；87례환자검측도1매동맥류。부65례환자적동맥류적형태재이유DSA상가청석현시。삼유VR-DSA발현13례액외동맥류，위우경내동맥（10례，77％），위우전교통동맥（3례，33％）。대뇌중동맥여추기저동맥미발현액외동맥류。결론삼유용적DSA불부능청석현시동맥류적대소급형태，이차능검측출이유DSA미검출적동맥류，특별시미소동맥류。
Objective To evaluate the diagnostic value of 3D VR-DSA for small intracranial aneurysm, espe-cially in depicting additional aneurysms missed by 2D DSA. Methods One hundred and twenty-nine consecutive patients with known or suspected aneurysms underwent both conventional DSA and 3D VR-DSA examination simulta-neously. Results 3D VR-DSA with showed 123 aneurysms in 105 (85%) of 129 patients, with one aneurysm in 90 patients each, two aneurysms in 12 patients each and 3 in 3 patients, and no aneurysms were found in 24 patients. The morphologic characteristics of all aneurysm could be clearly exhibited on 3D VR-DSA. 2D DSA showed 110 a-neurysms in 98 of 129 patients, with one aneurysm in 87 patients each, two aneurysms in 10 patients each and 3 in 1 patient. The morphologic characteristics of 65 aneurysms could be clearly exhibited on 3D VR-DSA. After reaching a consensus, there were 13 additional aneurysms detected by 3D VR-DSA. Thirteen aneurysms were<3 mm by maxi-mum diameter with 2 aneurysms ruptured. These additional aneurysms were located in internal carotid artery (ICA, n=10, 77%), anterior cerebral artery (ACA, n=3, 33%). No additional aneurysms were found in either middle cerebral artery (MCA) or vertebrobasilar and posterior cerebral artery (PCA) systems. Conclusions 3D VR-DSA not only clearly reveals aneurysms and aneurysmal morphology, but also detects additional aneurysms missed by 2D DSA, es-pecially small aneurysms less than 3 mm.