摘要
目的探讨4D-DSA在脑动静脉畸形(AVM)影像学评估中的临床应用价值。方法回顾性分析2018年1月至2019年1月收治的37例脑AVM的临床资料和影像学资料。所有病人均接受2D-DSA及4D-DSA序列采集,并在西门子DSA机4D工作站中进行4D-DSA影像重建。以2D-DSA、3D-DSA影像结果定义为标准诊断结果,2位具有副主任医师职称并且未参与手术治疗的神经外科介入医师对4D连续动态三维影像分别独立进行评估。结果37例中,SM分级Ⅲ级26,Ⅳ级9例;Ⅴ级2例。畸形血管团位于额叶8例、颞叶9例、顶叶3例、枕叶3例、小脑4例,其余10例畸形畸形团分布2个脑叶以上。4D-DSA在畸形血管团的评估中均与标准诊断结果均具有较强的一致性(一致性系数≥0.77)。在复杂畸形团评估中,4D-DSA对畸形血管团的血管结构显像更加精准。同时,4D-DSA对畸形团血流动力学评估结果与iFlow成像技术一致。结论4D-DSA与传统的2D-DSA及3DDSA相比,对脑AVM的血管构筑学,尤其是对病灶及血流动力学具有更清晰精准的显示,更能帮助提高脑AVM的诊治水平。
Objective To explore the value of 4D-DSA in the imaging evaluation of cerebral arteriovenous malformation(AVM).Methods The clinical data and imaging data of 37 patients with cerebral AVM treated from January,2018 to January,2019 were retrospectively analyzed.All the patients received 2D-DSA and 4D-DSA sequence examination,and the 4D-DSA image reconstruction was performed in Siemens DSA machine 4D workstation.The 2D-DSA and 3D-DSA imaging results were defined as the standard diagnostic results.The continuous dynamic 4D images were evaluated by 2 neurosurgical interventional physicians with titles of associate chief physicians who were not involved in surgical treatment.Results Of 37 patients,26 were SM gradeⅢ,9 gradeⅣ,and 2 gradeⅤ.Malformed vascular masses were located in the frontal lobe of 8 patients,the temporal lobe of 9,the parietal lobe of 3,the occipital lobe of 3 and the cerebellum of 4,and distributed in more than 2 cerebral lobes of 10.4D-DSA had a strong consistency with the standard diagnostic results in the evaluation of malformed vascular masses(coefficient of consistency≥0.77).In the evaluation of complex malformations,4D-DSA can more accurately show the vascular structure of malformed vascular masses.At the same time,the results of 4D-DSA's hemodynamic evaluation of deformed masses were consistent with iFlow imaging technology.Conclusion Compared with the traditional 2D-DSA and 3D-DSA,4D-DSA has a clearer and more accurate display of the angiology of the cerebral AVM,especially the lesions and hemodynamics,which can help to improve the diagnosis and treatment of the cerebral AVM.
作者
闫林海
潘力
杨铭
石纪
沈春发
黄河
秦杰
马廉亭
YAN Lin-hai;PAN Li;YANG Ming;SHI Ji;SHEN Chun-fa;HUANG He;QIN Jie;MA Lian-ting(School of Medicine,Wuhan University of Sciences and Technology,Wuhan 430065,China;Department of Neurosurgery,General Hospital of Central Theater Command,PLA,Wuhan 430070,China)
出处
《中国临床神经外科杂志》
2020年第3期134-137,共4页
Chinese Journal of Clinical Neurosurgery
