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山东大学学报（医学版） ›› 2014, Vol. 52 ›› Issue (11): 49-54.doi: 10.6040/j.issn.1671-7554.0.2014.161

• 临床医学 • 上一篇    下一篇

三维DSA在后交通动脉起始部病变鉴别诊断中的价值

杨显存1,2, 葛彦彦2, 刘强3, 于斌超2   

  1. 1. 山东大学医学院, 山东 济南 250012;
    2. 山东大学附属省立医院介入诊疗科, 山东 济南 250021;
    3. 山东大学山东省医学影像学研究所, 山东 济南 250021
  • 收稿日期:2014-03-24 发布日期:2014-11-10
  • 通讯作者: 刘强.E-mail:2002md@163.com E-mail:2002md@163.com

Value of 3D-digital subtraction angiography in the differential diagnosis of vascular lesion originating from the posterior communicating artery

YANG Xiancun1,2, GE Yanyan2, LIU Qiang3, YU Binchao2   

  1. 1. School of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Interventional Radiology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China;
    3. Shandong University, Medical Imaging Research Institute, Jinan 250021, Shandong, China
  • Received:2014-03-24 Published:2014-11-10

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摘要： 目的 探讨三维数字减影血管造影(3D-DSA)在鉴别诊断后交通动脉起始部动脉瘤与漏斗样扩张中的应用价值.方法 回顾性分析47例后交通动脉起始部病变的患者资料,所有患者均进行常规二维数字减影血管造影(2D-DSA)与3D-DSA检查,由2名医生对检查结果进行判断分析.结果 2D-DSA发现真阳性动脉瘤26例,漏斗样扩张6例,3D-DSA发现动脉瘤33例,漏斗样扩张14例, 2D-DSA与3D-DSA比较差异有统计学意义(χ2=19.03,P<0.05);对病变部位与周围血管间的关系显示中,两者比较差异有统计学意义(Z=-3.62,P<0.05).结论 三维DSA能清晰显示病变部位与毗邻血管之间的关系,在鉴别漏斗样扩张与动脉瘤的诊断中具有重要参考价值,值得推广.

关键词: 鉴别诊断, 数字减影血管造影, 三维重建, 漏斗样扩张

Abstract: Objective To explore the applicative value of three-dimensional digital subtraction angiography (3D-DSA) in diagnosing aneurysm and infundibular dilation (ID) originating from the posterior communicating artery. Methods A total of 47 patients with vascular lesions originating from the posterior communicating artery were analyzed retrospectively. All patients had undergone angiography with both conventional DSA (2D-DSA) and 3D-DSA, and the results were analyzed by two doctors. Results Altogether 26 aneurysms and 6 IDs were found by 2D-DSA, while 33 aneurysms and 14 IDs were detected by 3D-DSA, with a statistical significance between the detection rates (χ2=19.03, P<0.05). There was a statistical difference in displaying the relationship between the lesion and adjacent vessels (Z=-3.62, P<0.05). Conclusion The 3D-DSA can clearly display the relationship between the lesion and adjacent vessels, which is important in the differential diagnosis of ID and aneurysm, thus it is worthy of spreading.

Key words: Three dimensional, Differential diagnosis, Digital subtraction angiography, Infundibular dilation

中图分类号: 

  • R743.3
[1] 贾晓军, 陈阳, 张猛, 等. 脑血管介入中的血管变异及其临床意义[J]. 解剖与临床, 2008, 13(4):227-236. JIA Xiaojun, CHEN Yang, ZHANG Meng, et al. Anatomic Variation of Vessels and Its Clinical Significance for Cerebrovascular Intervention [J]. Anatomy and Clinics, 2008, 13(4):227-236.
[2] Endo S, Furuichi S, Takaba M, et al. Clinical study of enlarged infundibular dilation of the origin of the posterior communicating artery[J]. J Neurosurg, 1995, 83(3): 421-425.
[3] Shi W Y, Li Y D, Li M H, et al. Differential diagnosis of infundibular dilation versus a small aneurysm of the internal carotid artery: assessment by three-dimensional rotational angiography with volume rendering[J]. Neurol Sci, 2013, 34(7):1065-1070.
[4] Nashimoto T, Saito T, Kurashima A, et al. Rupture of a small aneurysm originating from an infundibular dilatation-case report [J]. Brain Nerve, 2009, 61(10):1177-1181.
[5] Takahashi C, Fukuda O, Hori E, et al. A case of infundibular dilatation developed into an aneurysm and rupturing after the rupture of an aneurysm 10 years ago[J]. No Shinkei Geka, 2006, 34(6):613-617.
[6] Baek H, Jayaraman M V, Karniadakis G E. Wall shear stress and pressure distribution on aneurysms and infundibulae in the posterior communicating artery bifurcation[J]. Ann Biomed Eng, 2009, 37(12):2469-2487.
[7] Beumer D, Delwel E J, Kleinrensink G J, et al. The perforator-free zone of the posterior communicating artery and its relevance in approaches to the interpeduncular cistern, especially the transcavernous approach: an anatomic study[J]. Neurosurgery, 2007, 61(5 Suppl 2):187-191.
[8] Adams W M, Laitt D, Jackson A. The role of MR angiography in the pretreatment assessment of intracranialaneurysms: a comparative study[J]. AJNR Am J Neuroradiol, 2000, 21(9):1618-1628.
[9] Satoh T, Onoda K, Tsuchimoto S. Visualization of intraaneurysmal flow patterns with transluminal flow images of 3D MR angiograms in conjunction with aneurysmal configurations[J]. AJNR Am J Neuroradiol, 2003, 24(7):1436-1445.
[10] Satoh T, Omi M, Ohsako C, et al. Differential diagnosis of the infundibular dilation and aneurysm of internal carotid artery: assessment with fusion imaging of 3D MR cisternography/Angiography[J]. AJNR Am J Neuroradiol, 2006, 27(2):306-312.
[11] 李江涛, 王朝华, 谢晓东, 等. 旋转DSA及三维重建技术在颅内动脉瘤诊断中的应用价值[J]. 实用放射学杂志, 2008, 24(2):145-147. LI Jiangtao, WANG Chaohua, XIE Xiaodong, et al. The application of rotational digital subtraction angiography and 3D reconstruction technique in diagnosing intracranial aneurysms [J]. J Pract Radiol, 2008, 24(2):145-117.
[12] 李健, 王祝峰, 王珩, 等. 3D DSA辅助下弹簧圈栓塞颅内微型动脉瘤[J]. 中华神经外科疾病研究杂志, 2011, 10(1): 61-64. LI Jian, WANG Zhufeng, WANG Heng, et al. Endovascular coiling of intracranial microaneurysms with the assistance of 3D DSA [J]. Chin J Neurosurg Dis Res, 2011, 10(1):61-64.
[13] Kucukay F, Okten R S, Tekiner A, et al. Three-dimensional volume rendering digital subtraction angiography in comparison with two-dimensional digital subtraction angiography and rotational angiography for detecting aneurysms and their morphological properties in patients with subarachnoid hemorrhage [J]. Eur J Radiol, 2012, 81(10):2794-2800.
[14] Shi W Y, Li Y D, Li M H, et al. 3D rotational angiography with volume rendering: the utility in the detection of intracranial aneurysms [J]. Neurol India, 2010, 58(6):908-913.
[15] van Rooij W J, Sprengers M E, de Gast A N, et al. 3D rotational angiography: the new gold standard in the detection of additional intracranial aneurysms[J]. AJNR Am J Neuroradiol, 2008, 29(5):976-979.
[16] Wong S C, Nawawi O, Ramli N, et al. Benefits of 3D rotational DSA compared with 2D DSA in the evaluation of intracranial aneurysm[J]. Acad Radiol, 2012, 19(6):701-707.
[17] 杨显存, 刘强, 葛彦彦, 等. 三维重建技术在颅内动脉瘤诊治中的影响因素[J]. 实用放射学杂志, 2013, 29(9):1529-1532. YANG Xiancun, LIU Qiang, GE Yanyan, et al. Influence factors of three-dimensional reconstruction technique in the diagnosis and treatment of intracranial aneurysm[J]. J Pract Radiol, 2013, 29(9):1529-1532.
[18] Yoshino M, Kin T, Shojima M, et al. A high-resolution method with increased matrix size can characterize small arteries around a giant aneurysm in three dimensions[J]. Br J Neurosurg, 2012, 26(6):927-928.
[19] 宁丹, 李彩霞, 李春海. 三维DSA与二维DSA在颅内动脉瘤诊疗中应用价值的比较[J]. 山东大学学报: 医学版, 2008, 46(4):403-406. NING Dan, LI Caixia, LI Chunhai. Comparison of 2D- and 3D-digital subtraction angiography in evaluation of intracranial aneurysms [J]. Journal of Shandong University: Health Sciences, 2008, 46(4):403-406.
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