摘要
目的探讨CTA联合3D Slicer三维重建技术辅助开颅夹闭术治疗颅内动脉瘤的疗效。方法回顾性分析2021年1月至2023年12月开颅夹闭术治疗的24例颅内动脉瘤的临床资料。术前将CTA数据导入3D Slicer软件进行三维重建分析动脉瘤特征,然后制定个体化手术方案。以术中情况作为参考标准,评估术前计划效果。结果根据术中观察,术前预判动脉瘤瘤体朝向、动脉瘤和血肿位置关系、载瘤动脉走行方向的判断明确。术前预判载瘤动脉狭窄情况与术中情况一致性极好(κ=0.865;P<0.001),术前预判瘤颈分离困难与术中情况一致性较高(κ=0.779;P<0.001)。术后24 h复查头颅CT未发现新发出血,术后7 d复查头颅CTA未见动脉瘤复发。术中发生动脉瘤再破裂1例,术后出现载瘤动脉远端区域梗死1例。结论CTA联合3D Slicer三维重建技术可准确评估颅内动脉瘤,并提供开颅夹闭术所需关键解剖信息以制定手术方案,有助于减少手术并发症。
Objective To evaluate the efficacy of surgical clipping assisted by CTA combined with 3D Slicer three-dimensional reconstruction technology for patients with intracranial aneurysms.Methods The clinical data of 24 patients with intracranial aneurysms treated by surgical clipping from January 2021 to December 2023 were retrospectively analyzed.Preoperatively,CTA data were imported into 3D Slicer software for three-dimensional reconstruction to analyze aneurysm characteristics,followed by the formulation of individualized surgical plans.Intraoperative findings served as the reference standard to assess the accuracy of preoperative planning.Results Based on intraoperative observations,preoperative predictions of aneurysm orientation,spatial relationships between aneurysms and hematomas,and the course of parent arteries were precise.Preoperative assessment of parent artery stenosis showed excellent agreement with intraoperative findings(κ=0.865;P<0.001).Preoperative prediction of aneurysm neck dissection difficulty demonstrated high consistency with intraoperative observations(κ=0.779;P<0.001).Postoperative cranial CT scans at 24 hours revealed no new hemorrhages,and cranial CTA at 7 days post-surgery showed no aneurysm recurrence.Intraoperative aneurysm rerupture occurred in one case,and postoperative infarction in the distal territory of the parent artery occurred in one case.Conclusion CTA combined with 3D Slicer three-dimensional reconstruction technology enables accurate evaluation of intracranial aneurysms and provides critical anatomical information for surgical clipping,which aids in reducing surgical complications.
作者
何川
曹刚
谭兴实
钟琦
雷永生
林晓鸿
陈尧坤
孙文晓
HE Chuan;CAO Gang;TAN Xing-shi;ZHONG Qi;LEI Yong-sheng;LIN Xiao-hong;CHEN Yao-kun;SUN Wenxiao(The Third School of Clinical Medicine,Southren Medical University,Zhuhai 519000,China;Department of Neurosurgery,Southern Medical University Affiliated Zhuhai Hospital(Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine),Zhuhai 519000,China)
出处
《中国临床神经外科杂志》
2025年第5期271-276,共6页
Chinese Journal of Clinical Neurosurgery
基金
广东省医学科学技术研究基金项目(B2025416)
珠海市卫生医学科研项目(2320009000010)
珠海市中西医结合医院院级科研项目(202306)。
关键词
颅内动脉瘤
开颅夹闭术
CTA
3D
Slicer三维重建技术
疗效
Intracranial aneurysms
Surgical clipping
CT angiography
3D Slicer three-dimensional reconstruction technology
