【摘要】 目的浅析"金标准"内3D-DSA技术较常规2D-DSA在神经介入中的诊断优势和治疗中的应用价值。方法收集昆明医科大学附属延安医院2018年1月至2019年12月使用2D及3D-DSA技术行神经介入患者277例。其中:脑血栓取栓111例、动脉瘤106例137个(普通囊状动脉瘤75例97个、巨大型动脉瘤5例6个、宽颈动脉瘤21例29个、夹层动脉瘤等2例2个、梭形动脉瘤2例2个、复杂型动脉瘤1例1个)、动静脉畸形45例、颈动脉狭窄支架置入15例。由工作经验丰富的2位副高以上阅片者采用双盲法对2D和3D的图像进行回顾性分析与测量,进而比较2D、3D图像测量数据差异及疾病检出率。结果 2D-DSA在普通脑血栓对各段血管的显示率与3D-DSA,差异无统计学意义(P> 0.05);2D-DSA检出动脉瘤93例(122个),3DDSA检出106例(137个)(P <0.05),不含假阳性2例;2D-DSA检出动静脉畸形44例,3D-DSA检出45例(P> 0.05);2D-DSA显示颈动脉狭窄15例,3D-DSA检出15例,差异无统计学意义(P> 0.05)。3D-DSA在颅内动脉瘤检出率、瘤颈、瘤体形态、瘤径、载瘤血管、穿支血管显示等方面显示效果明显优于2D-DSA。结论 3D-DSA技术提高了对神经性疾病的检出率;同时也提高了对疾病的定性、定量诊断准确率;并且对疾病的进一步治疗有重要的指导意义。更多还原

【Abstract】 Objective To analyse the diagnostic advantages and therapeutic value of 3 D-DSA compared with conventional 2 D-DSA in nerointervention in the " Gold Standard". Methods A total of 277 cases who underwent neurointerventional therapy using 2 D and 3 D-DSA were collected from the Affiliated Yan’a n Hospital of Kunming Medical University from January 2018 to December 2019,including 111 cases of cerebral thrombectomy,106 cases/137 aneurysms(97 common cystic aneurysms in 75 cases,6 giant aneurysms in 5 cases,29 wide neck aneurysms in 21 cases,2 dissecting aneurysms in 2 cases,2 spindle aneurysms in 2 cases,1 complex aneurysm in1 case),45 cases of arteriovenous malformation and 15 cases of carotid artery stenosis stent implantation. The 2 D and 3 D images were retrospectively analyzed and measured by two experienced radiologists using double-blind method, and then the difference of the measured data and the detection rate of the disease were compared.Results There was no significant difference between 2 D-DSA and 3 D-DSA in the detection rate of each segment of cerebral thrombosis(P > 0.05). 122 aneurysms(93 cases) were detected by 2 D-DSA,137 aneurysms(106 cases) were detected by 3 D-DSA(P < 0.05),excepted 2 false positive cases. 44 cases of AVM were detected by 2 DDSA and 45 cases were detected by 3 D-DSA(P > 0.05). 2 D-DSA showed carotid artery stenosis in 15 cases and 3 DDSA showed carotid artery stenosis in 15 cases,the difference was not statistically significant(P > 0.05). 3 D-DSA is significantly better than 2 D-DSA in the detection rate of intracranial aneurysm, tumor neck, tumor shape,tumor diameter,tumor tumor-bearing vessels,perforator vessel,etc. Conclusion 3 D-DSA technology improves the detection rate of neurological diseases, improves the accuracy of qualitative and quantitative diagnosis of neurological diseases;therefore it has important guiding significance for the further treatment of diseases.更多还原