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ID:32236175
大小:2.04 MB
页数:35页
时间:2019-02-02
《数字减影三维重建在颅内动脉瘤诊断中的作用分析》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、山西医科大学硕士学位论文数字减影三维重建在颅内动脉瘤诊断中的作用分析谬断甲嗣作用万研摘要【目的】研究数字减影血管造影(digitalsubtractionangiography,DSA)三维重建(three—dimensionalreconstruction)在颅内动脉瘤的影像诊断中的应用价值。【方法】使用荷兰PHILIPSA1luraXperFD20数字减影机,对42例蛛网膜下腔出血患者行普通二维DSA正侧位及旋转DSA检查,并行血管三维重建,获得关于动脉瘤的定位、方向、瘤颈、动脉瘤清晰度、载瘤动脉和周围血管分支的立体解剖
2、图像,将旋转DSA及三维影像与普通二维DSA结果比较。【结果】42例患者共发现48枚动脉瘤。36例为1枚动脉瘤,6例为2枚动脉瘤,42例患者中行颅内动脉瘤夹闭术38例,血管内治疗4例。2D—DSA共检出37例43枚动脉瘤,l例在2D—DSA上诊断为动脉瘤,经3D_DSA证实为正常血管返折、扩张。5例常规2D—DSA未发现动脉瘤,经3D_DSA诊断为5例6枚微小动脉瘤。3D—DSA对颅内动脉瘤的诊断率高于2D—DSA;2D—DSA图像中能清楚显示动脉血管,无明显伪影,在3D—DSA图像中有1例因配合欠佳出现严重伪影,影响图片质
3、量。但2D—DSA图像和3D—DSA图像,二者无统计学差别(P=0.977);3D—DSA对于动脉瘤瘤颈的显示、动脉瘤形态的显示、瘤颈和周围重要血管毗邻关系的评价优于2D—DSA(P4、t【obiects】ToeValuatether01eofthree—dimensional(3D)reconstmctofdi百talsubtractionaIl酉。黟aphy(DSA)inthedia印osisofintmcraIlialaneurysm.【Methods】PHILIPSAlluraXperFD20sySt锄wasemployedtoperfIo珊2D锄drotationalDSAex锄ination南r42patientsofintra渊ialaneul了smswimsllbaradmoidheInor5、rhage,alldtlle3Drecons仇lctionofthearteriesw嬲menperf6加edwithcomputertogainthest盯eopictureof10calization锄ddire“onoftheaIleu巧sms,sh印eandsizeofan嘶smalneck趾dVascularbmchanatomy.TherotationalDSAaIld3Dreconstmctedimageswerecomp鲫edwimthatofcoIⅣentional2D.DSA.【Results】48a116、eu巧smswere‰din42patients.Asindeaneulysmwasdetectedin46patients,6patieIltshaStwoa11伽【巧sms.Of42caSes,36caSeswere讹atedbysur斟,and4casesbythe伽【dovascularmerapy.43锄eurysmsiIl37patientsweref-oulldoutwitllmememodof2D-DSA.Thee11l叫量ementorback仃ackingofnomlalcerebralVesselswe7、reconfimledby3D—DSAinlcases,、)l,hichweresuspectedtobeaIleury锄swith2D—DSA.5mini—aIleurysmsin4patientsweredetectedwitll3D—DSA,butwerenotseenwith2D-DSA.3D—DSAwaSsi伊ificaIltlysup耐orto2D—DSA,inclinicaldia印osis.ForoVerallimagequality,the2D—DSAwasexcellentandt11e3D—DSAwas8、excellentexc印tlcase,becauseofmoVing,nostatisticallysignificantdi插:rencewasfoundbetween2D·DSAand3D-DSA,(P=O.977).Forvisualizationof锄eurysmsneck,co
4、t【obiects】ToeValuatether01eofthree—dimensional(3D)reconstmctofdi百talsubtractionaIl酉。黟aphy(DSA)inthedia印osisofintmcraIlialaneurysm.【Methods】PHILIPSAlluraXperFD20sySt锄wasemployedtoperfIo珊2D锄drotationalDSAex锄ination南r42patientsofintra渊ialaneul了smswimsllbaradmoidheInor
5、rhage,alldtlle3Drecons仇lctionofthearteriesw嬲menperf6加edwithcomputertogainthest盯eopictureof10calization锄ddire“onoftheaIleu巧sms,sh印eandsizeofan嘶smalneck趾dVascularbmchanatomy.TherotationalDSAaIld3Dreconstmctedimageswerecomp鲫edwimthatofcoIⅣentional2D.DSA.【Results】48a11
6、eu巧smswere‰din42patients.Asindeaneulysmwasdetectedin46patients,6patieIltshaStwoa11伽【巧sms.Of42caSes,36caSeswere讹atedbysur斟,and4casesbythe伽【dovascularmerapy.43锄eurysmsiIl37patientsweref-oulldoutwitllmememodof2D-DSA.Thee11l叫量ementorback仃ackingofnomlalcerebralVesselswe
7、reconfimledby3D—DSAinlcases,、)l,hichweresuspectedtobeaIleury锄swith2D—DSA.5mini—aIleurysmsin4patientsweredetectedwitll3D—DSA,butwerenotseenwith2D-DSA.3D—DSAwaSsi伊ificaIltlysup耐orto2D—DSA,inclinicaldia印osis.ForoVerallimagequality,the2D—DSAwasexcellentandt11e3D—DSAwas
8、excellentexc印tlcase,becauseofmoVing,nostatisticallysignificantdi插:rencewasfoundbetween2D·DSAand3D-DSA,(P=O.977).Forvisualizationof锄eurysmsneck,co
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