[1]李腾飞,马 骥,朱 明,等.高分辨C臂CT在颅内动脉瘤国产血流导向装置置入术中的应用[J].郑州大学学报(医学版),2019,(05):641-645.[doi:10.13705/j.issn.1671-6825.2019.06.101]
 LI Tengfei,MA Ji,ZHU Ming,et al.Application of high-resolution C-arm CT during national flow diverter implantation for intracranial aneurysm treatment[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(05):641-645.[doi:10.13705/j.issn.1671-6825.2019.06.101]
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高分辨C臂CT在颅内动脉瘤国产血流导向装置置入术中的应用()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2019年05期
页码:
641-645
栏目:
系列研究
出版日期:
2019-09-20

文章信息/Info

Title:
Application of high-resolution C-arm CT during national flow diverter implantation for intracranial aneurysm treatment
作者:
李腾飞马 骥朱 明朱 涛马 宝任建庄韩新巍
郑州大学第一附属医院放射介入科 郑州 450052
Author(s):
LI TengfeiMA JiZHU MingZHU TaoMA BaoREN JianzhuangHAN Xinwei
Department of Interventional Radiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052
关键词:
高分辨C臂CT 颅内动脉瘤 去金属伪影技术 介入手术
Keywords:
high-resolution C-arm CT intracranial aneurysm streak metal artifact removal technology interventional therapy
分类号:
R743.4
DOI:
10.13705/j.issn.1671-6825.2019.06.101
摘要:
目的:探讨高分辨C臂CT在颅内动脉瘤国产血流导向装置(Tubridge FD)置入术中的应用价值。方法:回顾性分析采用Tubridge FD治疗的21例颅内动脉瘤患者(20例为单侧,1例为双侧,共35个动脉瘤)的临床及影像学资料,比较术中FD置入区域普通C臂CT和高分辨C臂CT对FD铂铱双螺旋显影标记和镍钛编织金属丝的显影程度,以及支架和弹簧圈去金属伪影效果。术后第3、6个月采用改良Rankin 量表(mRS)进行评分。术后第3个月进行DSA检查,以OKM分级评价动脉瘤闭塞情况。记录术后1个月内和1个月以后并发症发生情况。结果:21例共置入22枚Tubridge FD,其中3例联合弹簧圈填塞治疗。高分辨C臂 CT图像FD铂铱双螺旋显影标记、镍钛编织金属丝的显影程度,以及去金属伪影效果均优于普通C臂CT(P<0.05)。术后第3个月行DSA检查,35个动脉瘤中OKM分级B级8(22.8%)个,C级10(28.6%)个,D级17(48.6%)个。术后第6个月末次mRS评分0分19例,1分2例。3例患者出现术中并发症,均为不同程度脑血管痉挛,对症处理后情况改善,无神经后遗症; 未发生术中动脉瘤破裂、脑实质出血及支架内血栓形成。结论:高分辨C臂CT能清晰展示Tubridge FD支架细节并降低弹簧圈金属伪影,有利于术者术中对FD打开和贴壁状况的判断。
Abstract:
Aim:To explore the value of high-resolution C-arm CT during national flow diverter(Tubridge FD)implantation for intracranial aneurysms.Methods:A total of 21 patients with intracranial aneurysms(20 patients with one side and 1 patients with both side, and 35 aneurysms in total)received Tubridge FD implantation. The images obtained from fluoroscopy conventional C-arm CT and the high-resolution C-arm CT were reviewed, and whether the stent was fully expanded by the high-resolution C-arm CT and C-arm CT with low concentration of contrast injection. Modified Rankin scale(mRS)was used to score efficacy 3 and 6 months after operation. DSA was performed 3 months after operation to evaluate the occlusion of aneurysms by OKM classification. The complications within 1 month and 1 month after operation were recorded.Results:A total of 21 patients were successfully conducted using 22 FD with 3 patients combined with coils.The visualization of meticulous structures of the stent, reduce of metal artifacts produced by the platinum coils of the high-resolution C-arm CT were improved compared with conventional C-arm CT(P<0.05). At the 3rd month after operation,out of the 35 aneurysms, 8(22.8%)had OKM grade B, 10(28.6%)had grade C and 17(48.6%)had grade D. At the 6th month after operation, 19 patients mRS scored 0, and 2 patients scored 1. Three patients had intraoperative complications, all of which were cerebral vasospasm of varying degrees. After symptomatic treatment, the condition was improved without neurological sequelae, and no intraoperative aneurysm rupture, cerebral parenchymal hemorrhage and stent thrombosis were found.Conclusion:The high-resolution C-arm CT can clearly display the details of Tubridge FD stent and reduce the metal artifacts of spring coil, which is helpful for the judgement of FD opening and adherence during operation.

参考文献/References:

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备注/Memo

备注/Memo:
【基金项目】国家自然科学基金项目(81801806)
【作者简介】韩新巍,通信作者,男,1958年6月生,博士,主任医师,研究方向:各类疾病的介入治疗,E-mail:hanxinwei2006@163.com
更新日期/Last Update: 2019-09-20