[1]周 兵,李明华,王 武,等.三维容积重建技术在栓塞后颅内动脉瘤DSA随访中的价值探讨[J].介入放射学杂志,2010,(10):762-766.
 ZHOU Bing,LI Ming-hua,WANG Wu,et al.The clinical value of 3-dimensional volume-rendering technique in the follow-up checkups with DSA for intracranial aneurysms after embolization treatment[J].journal interventional radiology,2010,(10):762-766.
点击复制

三维容积重建技术在栓塞后颅内动脉瘤DSA随访中的价值探讨()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2010年10期
页码:
762-766
栏目:
神经介入
出版日期:
2010-10-30

文章信息/Info

Title:
The clinical value of 3-dimensional volume-rendering technique in the follow-up checkups with DSA for intracranial aneurysms after embolization treatment
作者:
周 兵李明华王 武
浙江省人民医院介入科; 上海交通大学附属第六人民医院介入放射科;郑州大学附属第一医院介入科
Author(s):
ZHOU Bing LI Ming-hua WANG Wu WANG Jue XU Hao-wen YUAN Jian-hua
Department of Interventional Radiology, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China
关键词:
三维容积重建 数字减影血管造影 旋转造影 随访
分类号:
R743.4
文献标志码:
摘要:
目的   探讨三维容积重建技术(3DVRT)在弹簧圈栓塞后颅内动脉瘤的DSA随访中的应用价值。方法 采用介入弹簧圈栓塞技术治疗109例患者、共121枚颅内动脉瘤,术后所有患者均经历至少1次DSA随访。2名神经放射学专家分别对术后即刻和随访中的二维DSA造影(2DDSA)、旋转血管造影(rotational angiography, RA)和3DVRT成像进行分析,比较3种成像技术显示动脉瘤残留的能力。术后随访结果分为完全栓塞、瘤颈残留和瘤腔残留。若患者经历1次以上造影随访,评估最后一次随访结果。采用KruskalWallis等级秩和检验对3种成像技术的评价结果进行比较,Kappa检验评价2名观察者结果的一致性。结果 121枚动脉瘤术后3DVRT显示90枚完全栓塞,26枚瘤颈残留,5枚瘤腔残留。在随访造影中,2DDSA发现完全栓塞、瘤颈残留和瘤腔残留分别为92枚、20枚和9枚,RA发现例数为86枚、23枚和12枚,3DVRT为68枚、30枚和23枚,3组间比较差异有统计学意义(χ2 = 14.052, P = 0.000 9)。2名观察者对于2DDSA、RA和3DVRT观察结果的Kappa值分别为0.545、0.582和0.748。结论 3DVRT技术能够明显提高DSA造影随访中动脉瘤残留的检出率,值得在栓塞动脉瘤的造影随访中推广使用。

参考文献/References:

[1] Hirai T, Korogi Y, Suginohara K, et al. Clinical usefulness of unsubtracted 3D digital angiography compared with rotational digital angiography in the pretreatment evaluation of intracranial aneurysms[J]. AJNR, 2003, 24: 1067 - 1074.
[2] 吴春红, 陈左权, 顾斌贤, 等. 旋转DSA三维重建成像与常规DSA成像在动脉瘤瘤颈大小测量中的比较[J]. 介入放射学杂志, 2006, 15: 259 - 260.
[3] Hassan T, Timofeev EV, Saito T, et al. Computational replicas: anatomic reconstructions of cerebral vessels as volume numerical grids at three-dimensional angiography[J]. AJNR, 2004, 25: 1356 - 1365.
[4] Piotin M, Gailloud P, Bidaut L, et al. CT angiography, MR angiography and rotational digital subtraction angiography for volumetric assessment of intracranial aneurysms. An experimental study[J]. Neuroradiology,2003, 45: 404-409.
[5] Loh Y, McArthur DL, Tateshima S, et al. Safety of intracranial endovascular aneurysm therapy using 3-dimensional rotational angiography: a single-center experience[J]. Surg Neurol, 2008, 69: 158 - 163.
[6] Anxionnat R, Bracard S, Macho J, et al. 3D angiography. Clinical interest. First applications in interventional neuroradiology[J]. J Neuroradiol, 1998, 25: 251 - 262.
[7] Anxionnat R, Bracard S, Ducrocq X, et al. Intracranial aneurysms: clinical value of 3D digital subtraction angiography in the therapeutic decision and endovascular treatment[J]. Radiology, 2001, 218: 799 -808.
[8] Grunwald IQ, Papanagiotou P, Struffert T, et al. Recanalization after endovascular treatment of intracerebral aneurysms[J]. Neuroradiology, 2007, 49: 41 - 47.
[9] Raymond J, Guilbert F, Weill A, et al. Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils[J]. Stroke, 2003, 34: 1398 - 1403.
[10] 张 鹤, 李明华, 方 淳, 等. 3.0T时间飞跃法MRA诊断颅内动脉瘤—与DSA对照[J]. 介入放射学杂志, 2008, 19: 618 - 622.
[11] Westerlaan HE, van der Vliet AM, Hew JM, et al. Time-of-flight magnetic resonance angiography in the follow-up of intracranial aneurysms treated with Guglielmi detachable coils[J]. Neuroradiology, 2005, 47: 622 - 629.
[12] 朱玉森, 张丽娜, 徐 克, 等. 三维时间飞跃法MR血管造影血液铸型诊断颈内动脉系颅内动脉瘤的优势[J]. 中华放射学杂志, 2004, 38: 377 - 381.
[13] Urbach H, Dorenbeck U, von Falkenhausen M, et al. Three-dimensional time-of-flight MR angiography at 3T compared to digital subtraction angiography in the follow-up of ruptured and coiled intracranial aneurysms: a prospective study[J]. Neuroradiology, 2008, 50: 383 - 389.
[14] Brunereau L, Cottier JP, Sonier CB, et al. Prospective evaluation of time-of-flight MR angiography in the follow-up of intracranial saccular aneurysms treated with Guglielmi detachable coils[J]. J Comput Assist Tomogr, 1999, 23: 216 - 223.

相似文献/References:

[1]尹国文,徐清宇,白向君,等.透视引导下经鼻置入瘘腔引流管治疗食管癌术后食管胃吻合口瘘[J].介入放射学杂志,2012,(02):140.
 YIN Guo-wen,XU Qing-yu,BAI Xiang-jun,et al.Fluoroscopically-guided transnasal tube insertion for the treatment of gastroesophageal anastomotic leak occurred after surgery for esophageal carcinoma[J].journal interventional radiology,2012,(10):140.
[2]庄奇新.亚段肺栓塞的肺动脉造影诊断——10例分析[J].介入放射学杂志,1992,(01):23.
[3]萧湘生,欧阳强,郝楠馨,等.支气管动脉灌注并栓塞治疗肺癌[J].介入放射学杂志,1994,(01):45.
[4]曾晓华,王颂章.颈外动脉选择性栓塞在颌面外科的应用[J].介入放射学杂志,1995,(04):212.
[5]陈左权,顾斌贤,张桂运,等.双C臂三维DSA在颅内动脉瘤栓塞治疗中的应用[J].介入放射学杂志,2006,(01):2.
 CHEN Zuo-quan,GU Bin-xian,ZHANG Gui-yun,et al.The utility of three dimentional DSA with bi-C-typed arms in the embolization of intracranial aneurysms[J].journal interventional radiology,2006,(10):2.
[6]董敏俊,范新东,石润杰.鼻咽血管纤维瘤术前双重介入栓塞的临床价值[J].介入放射学杂志,2006,(06):342.
 DONG Min-jun,FAN Xin-dong,SHI Run-jie.Clinical value of pre-operative double embolization for nasopharyngeal angiofibroma[J].journal interventional radiology,2006,(10):342.
[7]郭德文,叶剑定,凌美玲,等.时差减影法临床应用及其在心脏疾患中诊断价值的探讨[J].介入放射学杂志,1996,(02):64.
[8]李 杰,赵俊功,朱悦琦,等.小腿加压3.0 T MRA评估糖尿病下肢血管病变的价值探讨[J].介入放射学杂志,2011,(03):231.
 LI Jie,ZHAO Jun-gong,ZHU Yue-qi,et al.Evaluation of diabetic peripheral arterial disease in lower limb by using 3.0 T contrast-enhanced MR angiography with simultaneous calf compression[J].journal interventional radiology,2011,(10):231.
[9]曹厚德.正在使用二甲双胍的糖尿病患者不宜作DSA造影检查[J].介入放射学杂志,2011,(05):339.
[10]李 臻,韩新巍,焦德超,等.C臂CT引导下靶向穿刺术在非血管介入诊疗中的应用[J].介入放射学杂志,2011,(07):544.
 LI Zhen,HAN Xin-wei,JIAO De-chao,et al. Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional biopsy or interventional therapy[J].journal interventional radiology,2011,(10):544.

备注/Memo

备注/Memo:
收稿日期:20100412
更新日期/Last Update: 2010-10-30