摘要
目的比较DSA减影与非减影容积重建技术在颅内动脉瘤介入诊疗中的应用价值,探讨两种重建技术的特点,为临床应用提供更好的重建方式。资料与方法回顾性分析27例脑蛛网膜下腔出血(SAH)患者及19例动脉瘤介入栓塞术后随访患者,均行旋转脑血管造影检查,分别采用非减影、DSA减影两种方式进行三维容积重建,比较两种重建技术对动脉瘤检出情况、图像质量及动脉瘤介入栓塞术后随访结果。结果 27例采用三维数字血管造影(3D-DA)的SAH患者检出动脉瘤33枚,假阳性2例;3D-DSA检出动脉瘤33枚,无假阳性病例,两者对动脉瘤的检出率差异无统计学意义(χ2=1.943,P>0.05),三维重建图像质量差异无统计学意义(Z=-1.445,P>0.05)。19例动脉瘤介入术后患者,3D-DA检出瘤体残留3例,3D-DSA检出瘤体残留10例,差异有统计学意义(χ2=5.729,P<0.05)。结论在颅内动脉瘤的介入诊疗中,3D-DA、3D-DSA均可以很好地检出动脉瘤并提供较好的图像质量;在判断动脉瘤的栓塞程度及介入术后随访中,3D-DSA能显示更多细小的血管信息,对术后残留动脉瘤的检测具有更多的优势。
Purpose To explore and compare subtracted and unsubtracted volume rendering process on DSA apparatus in the diagnosis and treatment of intracranial aneurysms, and to provide a better reconstruction in clinic. Materials and Methods Twenty-seven patients with subarachnoid hemorrhage（SAH） underwent rotational cerebral angiography and 19 cases with embolization treatment underwent rotational cerebral angiography follow-up. 3D volume unsubtracted reconstruction and subtracted reconstructions were used respectively. Two sets of 3D volume reconstruction images were observed and analyzed by two neuroradiologists to compare the detection rate, image quality and post-embolization follow up. Results Thirty-three intracranial aneurysms were identified in 27 cases with SAH underwent three-dimensional digital angiography（3D-DA）. False positives were found in 2 cases. 3D-DSA detected 33 intracranial aneurysms with no false positive case. There was no statistical significance in intracranial aneurysms detection rate（χ^2=1.943, P〈0.05）. There was no statistical significance in image quality of two reconstruction methods（Z=- 1.445, P〈0.05）. In 19 cases with embolization treatment underwent the follow-up of rotational cerebral angiography, 3D-DA detected 3 cases with aneurysm remnants, while 3D-DSA detected 10. There was statistical significance between 3D-DA and 3D-DSA when detecting aneurysm remnant（χ^2=5.729, P〈0.05）. Conclusion Aneurysms can be well detected with better image quality by 3D-DSA and 3D-DA in the diagnosis and treatment of intracranial aneurysms. 3D-DSA can display more information on tiny vessels, and is better in detecting aneurysm remnants.
出处
《中国医学影像学杂志》
CSCD
北大核心
2015年第7期506-509,共4页
Chinese Journal of Medical Imaging
关键词
颅内动脉瘤
蛛网膜下腔出血
栓塞
治疗性
血管造影术
数字减影
脑血管造影术
图像处理
计算机辅助
Intracranial aneurysm
Subarachnoid hemorrhage
Embolization
therapeutic
Angiography
digital subtraction
Cerebral angiography
Image processing
computer-assisted
