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目的探讨三维重建技术在颅内动脉瘤显微外科治疗和血管内治疗中的价值。方法 对 76例可疑为颅内动脉瘤的患者分别进行常规的脑血管造影、数字减影血管造影 (DSA)和三维数字减影血管造影 (3D DSA) ,共检出 66例动脉瘤 (共 72个动脉瘤 ) ,根据影像结果拟定显微外科治疗和血管内治疗的治疗方案。结果 76例可疑为颅内动脉瘤的患者行普通脑血管造影和DSA检查 49例 ,显示脑动脉瘤的阳性率为 81 6 % ;行 3D DSA检查 2 7例 ,清楚显示动脉瘤的阳性率为 96 3 % ,共检出66例动脉瘤。显微外科治疗组 36例 ,完全夹闭 31例 (86 1 % ) ,死亡 2例 (5 6 % ) ,并发症 5例(1 39% )。血管内治疗组 2 3例 ,完全栓塞者 1 9例 (82 6 % ) ,90 %以上栓塞 2例 ,载瘤动脉闭塞 2例 ,并发症 2例 (0 87% ) ,无死亡病例。 66例动脉瘤中有 7例未治疗。结论 3D DSA能够提高自发性蛛网膜下腔出血 (SAH)脑动脉瘤的检出率 ,清楚显示脑动脉瘤的立体形态、瘤颈和载瘤动脉的关系 ,对指导颅内动脉瘤的显微外科治疗和血管内治疗有潜在的临床价值
Objective To investigate the value of three-dimensional reconstruction in intracranial aneurysm microsurgery and endovascular treatment. Methods Sixty-six patients with intracranial aneurysms were examined by conventional cerebral angiography, digital subtraction angiography (DSA) and three-dimensional digital subtraction angiography (3D DSA). A total of 66 aneurysms An aneurysm), according to the results of imaging microsurgery and endovascular treatment planning. Results Of the 76 patients with suspected intracranial aneurysm, 49 patients underwent routine cerebrovascular angiography and DSA examinations, which showed a positive rate of 81.6% in cerebral aneurysms. Twenty-seven patients underwent 3D DSA examination, which showed that the positive rate of aneurysm was 96 3%, a total of 66 cases of aneurysms were detected. Thirty-six patients were treated with microsurgery. There were 31 patients (86.1%) were completely clamped, 2 patients died (56%) and 5 patients (13 39%) were treated by microsurgery. In the endovascular group, 23 cases were completely embolized (82.6%), 2 cases were over 90% embolization, 2 were occlusion of the artery and 2 were complications (0 87%). There were no deaths. Seven of the 66 aneurysms were untreated. Conclusion 3D DSA can improve the detection rate of cerebral aneurysm in spontaneous subarachnoid hemorrhage (SAH), clearly show the relationship between the morphology of aneurysm, the tumor neck and the parent artery, Surgical treatment and endovascular treatment have potential clinical value