Wachter D, Psychogios M, Knauth M, Rohde V
Neurochirurgie, Georg-August-University Göttingen, Robert-Koch-Strasse 40, Göttingen,Germany.
Cent Eur Neurosurg. 2010 Aug;71(3):121-5. doi: 10.1055/s-0030-1261946. Epub 2010 Aug 19.
After clipping of intracranial aneurysms, digital subtraction angiography (DSA) is recommended for the proof of complete aneurysm occlusion or identification of aneurysm remnants, especially in cases with a more complex angioarchitecture or a difficult operative course. The aim of this study was to evaluate if postoperative intravenous angiographic computed tomography (ivACT) could be a diagnostic alternative in cases of contraindications for DSA.
13 patients (12 female, 1 male) underwent surgical clipping of 5 ruptured and 10 innocent aneurysms. Postoperative ivACT was performed in all patients due to refusal or contraindications for DSA.
12 patients had almost complete aneurysm clipping, while 1 patient's was incomplete, which was diagnosed by ivACT and confirmed by subsequent postoperative digital subtraction angiography (DSA), which had been accepted by the patient after clarification of the postoperative findings.
This study illustrates the efficacy of ivACT for postoperative control of surgically treated aneurysms. The quality of ivACT generated images seems to be sufficient in the detection of residual aneurysms after clipping. In cases with inconclusive results, postoperative DSA should be performed to obtain further details.
颅内动脉瘤夹闭术后，推荐采用数字减影血管造影（DSA）来证实动脉瘤是否完全闭塞或识别动脉瘤残端，尤其是在血管结构较为复杂或手术过程困难的病例中。本研究的目的是评估术后静脉血管造影CT（ivACT）在DSA禁忌证的情况下是否可作为一种诊断替代方法。
13例患者（12例女性，1例男性）接受了5例破裂动脉瘤和10例未破裂动脉瘤的手术夹闭。由于患者拒绝或存在DSA禁忌证，所有患者均接受了术后ivACT检查。
12例患者的动脉瘤几乎完全夹闭，1例夹闭不完全，通过ivACT诊断并经随后的术后数字减影血管造影（DSA）证实，术后结果向患者解释清楚后患者接受了DSA检查。
本研究说明了ivACT在手术治疗动脉瘤术后复查中的有效性。ivACT生成图像的质量似乎足以检测夹闭术后的残余动脉瘤。在结果不明确的情况下，应进行术后DSA以获取更多细节。
