【摘要】 目的评价双C臂三维DSA在颅内动脉瘤栓塞治疗中的应用价值。方法对8例自发性蛛网膜下腔出血患者行常规正、侧位和各种斜位及三维旋转造影,并进行三维重建。在工作站上寻找显露动脉瘤最佳视角,利用系统的自动定位功能使双C臂机架自动转到最佳工作角度,在此工作角度栓塞动脉瘤。结果在8例自发性蛛网膜下腔出血患者中检出动脉瘤,其中微小动脉瘤1例,动脉瘤小泡(动脉瘤壁上的小阜)4例(6个动脉瘤小泡)。选择栓塞治疗的6例患者中5例致密填塞,再次造影动脉瘤小泡不显影,1例次全填塞,微小动脉瘤未予治疗,另1例选择手术治疗。结论双C臂三维DSA有助于发现颅内动脉瘤、微小动脉瘤、动脉瘤小泡,能为动脉瘤栓塞治疗提供最佳的工作角度,使动脉瘤的栓塞更加安全可靠。更多还原

【Abstract】 Objective To discuss the value of three dimensional DSA(3D-DSA) with bi-C-typed arms on the embolization of intracranial aneurysms.Methods 3D-DSA was performed in eight patients (aged 43～73 years) with spontaneous subarachnoid hemorrhage(SAH) by frontal, lateral and various oblique projections including rotational angiography and three dimensional reconstruction. The perfect vision angle of aneurysms could be found on the 3D-workstation by the auto positioning function of 3D-DSA which could send the parameters to the main machine and make the bi-C-typed arms turning to the proper angle to have aneurysms embolized totally. Results Eight SAH cases were found with aneurysms including one micro-aneurysm and four with bleb (6 blebs). Six cases were under-taken selective embolization with 5 of total occlusion showing no bleb in follow up angiography and the other one of partial occlusion. The patient with micro-aneurysm didn′t receive embolization and another one received microneurosurgery operation. No blebs were found in the follow up angiography.Conclusions 3D-DSA with bi-C-typed arms can facilitate in finding intracranial aneurysms, micro-aneurysms and blebs′ and provide the best procedural angulation for embolization with more safe.更多还原