摘要
目的探讨4D-DSA在硬脑膜动静脉瘘(DAVF)诊断和治疗中的应用价值。方法回顾性分析2018年3月到2019年10月采用4D-DSA诊断和指导血管内栓塞治疗的10例DAVF的临床资料及影像学资料,对其血管构筑学进行系统分析,并通过彩色血流全循环成像(iFlow)技术进行对比分析。结果10例病人4D-DSA均可以清晰看到DAVF的瘘口(微孔复合体)、血管构筑和血流动力学流向,完成Cognard分型,并在4D-DSA引导下行血管内栓塞治疗。栓塞治疗后,10例病人iFlow结果显示患侧颈内动脉分叉部、大脑中动脉分叉部、窦汇区的造影剂达峰时间较术前明显缩短(P<0.05)。结论4D-DSA不仅可以对DAVF的血管构筑学、血流动力学有直观地理解,完成其分型和分类,并且可优化手术治疗方案。
Objective To explore the value of 4D-DSA to the diagnosis and treatment of dural arteriovenous fistulas(DAVF).Methods The clinical data and imaging data of 10 patients with DAVF diagnosed using 4D-DSA and treated with endovascular embolization under the guidance of 4D-DSA from March 2018 to October 2019 were analyzed retrospectively.The vascular architecture was systematically analyzed by 4D-DSA.The results of 4D-DSA were compared with the results of iFlow imaging.Results The 4D-DSA images of 10 patients clearly showed the fistulas(microporous complex),vascular structure and hemodynamic flow direction of DAVF.The Cognard classification was completed by 4D-DSA.The endovascular embolization was performed successfully in all the patients under the guidance of 4D-DSA.After embolization,the iFlow imaging results of 10 patients showed that the times to peak of contrast medium in the affected internal carotid artery bifurcation,middle cerebral artery bifurcation,and sinus confluence area were significantly lower than before surgery(P<0.05).Conclusions The 4D-DSA can intuitively understand the vascular architecture and hemodynamics of DAVF,complete the typing and classification of DAVF,and optimize the surgical treatment plan for DAVF.
作者
张敏
杨铭
潘力
秦杰
黄河
赵曰圆
向伟楚
吕福群
马廉亭
野路明
ZHANG Min;YANG Ming;PAN Li;QIN Jie;HUANG He;ZHAO Yue-yuan;XIANG Wei-chu;LV Fu-quan;MA Lian-ting;YE Lu-ming(School of Medicine,Wuhan University of Sciences and Technology,Wuhan 430065,China;Department of Neurosurgery,General Hospital of Central Theater Command,PLA,Wuhan 430070,China)
出处
《中国临床神经外科杂志》
2020年第3期129-133,共5页
Chinese Journal of Clinical Neurosurgery
关键词
硬脑膜动静脉瘘
四维数字减影血管造影
血管构筑学
血流动力学
血管内栓塞
Dural arteriovenous fistulas
Vascular architecture
Four-dimensional angiography
Haemodynamics
Endovascular embolization
