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脑动脉瘤的旋转血管造影评估

Rotational angiography assessment of cerebral aneurysms.

作者信息

Hoff D J, Wallace M C, terBrugge K G, Gentili F

机构信息

Department of Radiology, Toronto Hospital-Western Division, Ontario, Canada.

出版信息

AJNR Am J Neuroradiol. 1994 Nov;15(10):1945-8.

Abstract

PURPOSE

To compare rotational angiography with conventional digital subtraction angiography in the assessment of cerebral aneurysms.

METHODS

Conventional digital subtraction angiography and rotational angiography were compared in 57 patients investigated for the preoperative diagnosis of subarachnoid hemorrhage and in 13 patients after surgery. Images were compared for location, visibility of the aneurysmal neck, vascular branch anatomy, projection, size, presence of spasm, and shape of the aneurysm.

RESULTS

Rotational angiography was superior to the digital angiogram in assessing aneurysms and vascular anatomy in the following percentage of cases: 12% for location, 46% for the presence of a neck, 32% in the assessment of branch anatomy, 19% for projection, 12% for size, 3.5% for spasm, and 19% for shape. After surgery, rotational angiography more clearly demonstrated the presence or absence of a neck in 69% of the cases.

CONCLUSIONS

Rotational angiography often allows better visualization of vascular anatomy and therefore improves the angiographic assessment of aneurysms when compared with conventional digital subtraction angiography, making it an excellent adjunct in the investigation of subarachnoid hemorrhage. The lack of subtraction artifacts from the surgical clips and multiple angles of view also allow better assessment of the presence or absence of a residual neck in postoperative cases.

摘要

目的

比较旋转血管造影与传统数字减影血管造影在评估脑动脉瘤方面的效果。

方法

对57例因蛛网膜下腔出血进行术前诊断的患者以及13例术后患者的传统数字减影血管造影和旋转血管造影进行比较。比较图像的动脉瘤位置、瘤颈可视性、血管分支解剖结构、投影、大小、痉挛情况以及动脉瘤形状。

结果

旋转血管造影在评估动脉瘤和血管解剖结构方面优于数字血管造影的病例百分比分别为:位置12%、瘤颈显示46%、分支解剖结构评估32%、投影19%、大小12%、痉挛3.5%、形状19%。术后,旋转血管造影在69%的病例中更清晰地显示了瘤颈的有无。

结论

与传统数字减影血管造影相比,旋转血管造影通常能更好地显示血管解剖结构,从而改善对动脉瘤的血管造影评估,使其成为蛛网膜下腔出血检查中的一项出色辅助手段。手术夹无减影伪影以及多角度观察也有助于更好地评估术后病例中有无残留瘤颈。

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