摘要
目的探讨DSA与MRI或MRA双三维影像融合技术条件与要点及对颅内大与巨大型动脉瘤诊断、对脑深部微小动脉瘤与静脉瘤实施神经导航手术的价值。方法早期应用手工操作,目前在Siemens Artis Zee Biplane双大平板DSA机的SystemSyngo X-WP三维后处理工作站上,将符合三维融合条件的DSA与MRI或MRA影像数据,利用Inspace 3D-3D-Fustion软件分析合并数据后,将DSA与MRI或MRA双三维影像进行融合,获得融合后影像供临床诊断、评估颅内大与巨大型动脉瘤以及治疗脑深部小型动脉瘤、静脉瘤时输入神经导航实施手术。结果对1例左颈内动脉后交通巨大型动脉瘤伴血栓形成病人,通过DSA与MRI或MRA双三维融合影像,提高了巨大型动脉瘤血管內治疗前后对瘤体大小及瘤内血栓与临床占位效应相关性的认识;对1例脑室岀血铸型病人,经DSA确诊为moyamoya病合并胼胝体下室旁脉络膜后动脉血流相关性动脉瘤及1例脑深部动静脉畸形合并血流相关性静脉瘤病人成功实施了神经导航手术。结论 DSA与MRI或MRA双三维影像融合是一项用特制软件后处理新技术,融合后三维影像对颅内大与巨大型动脉瘤的诊断有新认识,发现DSA影像瘤体小于MRI影像瘤体而大于MRA影像瘤体,以及对脑深部血流相关性动脉瘤及静脉瘤融合数据输入神经导航实施手术有很高应用价值。
Objective To explore the technical condition and main points of ＂DSA and MRI or MRA three-dimensional（3D）-images fusions＂ technique and their values to to the cerebrovascular disease.MethodsDSA and MRI or MRA 3D-images fusionstechnique was used early by manual manipulation, and recently by System Syngo X-WP 3D post-processing workstation of SiemensArtis zee biplane DSA machine. DSA and MRI or MRA images data eligible for 3D-images fusion were analyzed and combined throughInspace 3D-3D-Fusion special software, and then the DSA and MRI or MRA images were fused. DSA and MRI or MRA 3D-imagesfusions were performed in 3 patients with cerebrovascular disease, including 1 case of giant posterior communicating artery, 1 case ofmoyamoya disease accompanied with blood flow-associated posterior choroid artery aneyrysms and 1 case of cerebral arteriovenousmalformation in deep right temporal lobe accompanied with venous aneurysm. The later two of three patients were treated byneuronavigator-assisted surgery under the guidance of 3D-images fusions.ResultsThe understanding of the size, intraaneurysmalthrombus and mass effect of the giant intracranial aneurysm was improved by the dual 3D-images fusions of DSA and MRI, and DSA andMRA. The neuronavigator-assisted surgery was performed under the guidance of DSA and MRI or MRA 3D-images fusions in the othertwo patients with cerebrovascular disease.ConclusionDSA and MRI or MRA 3D-images fusion is a new images post-processingtechnique with special software. Three-dimensional image fusion is certainly valuable for the diagnosis of cerebrovascular disease andthe neuronavigator-assisted surgery for deep brain blood flow-associated aneurysm and venous aneurysm.
出处
《中国临床神经外科杂志》
2015年第2期65-70,共6页
Chinese Journal of Clinical Neurosurgery
基金
湖北省医学临床研究中心项目(JX4D12)
湖北省科技计划研究与开发项目(2010BCB012)
关键词
颅内动脉瘤
DSA
MRI
MRA
三维影像融合
Cerebrovascular disease
Digital subtraction angiography
Magnetic resonance imaging
Image fusion
