CAJ | 학술논문

目的探讨平板数字减影血管成像(DSA)三维旋转血管造影(3DRA)在颅内微小动脉瘤(≤3mm)诊疗中的应用价值.资料与方法88例蛛网膜下腔出血患者利用平板 DSA 行常规全脑血管造影,再行3DRA 检查,并利用其工作站行三维重建,分析其二维(2D)与3DRA 显示颅内动脉瘤的差异,并分析3DRA 对微小动脉瘤的最佳显示角度,制订血管内栓塞治疗方案.结果平板DSA 常规全脑血管造影检出颅内动脉瘤69例,微小动脉瘤1例;利用其3DRA 检出动脉瘤82例,微小动脉瘤14例.13例3DRA 显示而2D 未显示的颅内动脉瘤均为微小动脉瘤,两者在动脉瘤检出率方面(93.18%对78.41%)差异有统计学意义(χ2=13.000, P <0.05).14例微小动脉瘤中,2例行血管内栓塞治疗,7例行外科手术治疗.结论3DRA 显著提高了颅内微小动脉瘤的检出率,是颅内微小动脉瘤诊断和栓塞治疗的有力工具.
목적탐토평판수자감영혈관성상(DSA)삼유선전혈관조영(3DRA)재로내미소동맥류(≤3mm)진료중적응용개치.자료여방법88례주망막하강출혈환자이용평판 DSA 행상규전뇌혈관조영,재행3DRA 검사,병이용기공작참행삼유중건,분석기이유(2D)여3DRA 현시로내동맥류적차이,병분석3DRA 대미소동맥류적최가현시각도,제정혈관내전새치료방안.결과평판DSA 상규전뇌혈관조영검출로내동맥류69례,미소동맥류1례;이용기3DRA 검출동맥류82례,미소동맥류14례.13례3DRA 현시이2D 미현시적로내동맥류균위미소동맥류,량자재동맥류검출솔방면(93.18%대78.41%)차이유통계학의의(χ2=13.000, P <0.05).14례미소동맥류중,2례행혈관내전새치료,7례행외과수술치료.결론3DRA 현저제고료로내미소동맥류적검출솔,시로내미소동맥류진단화전새치료적유력공구.
Purpose To evaluate the clinical applications of flat panel routine DSA with 3D rotational angiography (3DRA) in very small intracranial aneurysms ( ≤ 3mm). Materials and Methods 88 cerebral angiographic cases of subarachnoid haemmorage were performed using flat panel DSA with routine DSA and 3DRA techniques. Multiplane reconstruction was processed on workstation. Then the differences between routine DSA and 3DRA were further analyzed and evaluated for therapeutic efficacy by 3DRA. Results Cerebral aneurysms were found in only 69 patients using flat panel routine DSA with one very small intracranial aneurysm. 82 patients with subarachnoid hemorrhage were diagnosed by 3DRA, and very small intracranial aneurysms in 14 patients. 13 very small intracranial aneurysms were not found by 2D DSA. There was statistically significant difference in the visualization of aneurysms between 3DRA and 2D (χ2=13.000, P < 0.05). Two out of 14 patients with very small intracranial aneurysms underwent interventional embolic therapy;seven patients underwent surgical treatment. Conclusion 3DRA can significantly increase the diagnostic accuracy of very small intracranial aneurysms, and it is valuable for treatment planning. Therefore, implementation of 3DRA is an extremely useful tool in the treatment of very small intracranial aneurysms.