本文選題：動(dòng)脈瘤夾閉不全 + 顱內(nèi)動(dòng)脈瘤�。� 參考：《臨床放射學(xué)雜志》2016年05期

【摘要】：目的評(píng)價(jià)顱內(nèi)動(dòng)脈瘤術(shù)后夾閉不全和載瘤動(dòng)脈閉塞的CT血管造影(CTA)表現(xiàn),分析導(dǎo)致夾閉不全和載瘤動(dòng)脈閉塞的可能原因。方法回顧性分析118例顱內(nèi)動(dòng)脈瘤夾閉術(shù)后患者的CTA資料,使用64層螺旋CT掃描和多平面重組(MPR)、最大密度投影(MIP)、容積再現(xiàn)(VR)圖像后處理技術(shù),并與數(shù)字造影血管造影(DSA)對(duì)照,評(píng)價(jià)術(shù)后載瘤動(dòng)脈的CTA表現(xiàn),尤其是瘤夾的位置、夾閉不成功時(shí)殘存瘤體的形態(tài)。結(jié)果 112例載瘤動(dòng)脈通暢,6例經(jīng)DSA證實(shí)有動(dòng)脈瘤夾閉不全(5例)和載瘤動(dòng)脈閉塞(1例)。所有鈦夾顯示清楚,無(wú)偽影。動(dòng)脈瘤夾閉不全在CTA上表現(xiàn)為瘤夾周圍殘存小結(jié)節(jié)狀、錐狀、泡狀或囊袋狀動(dòng)脈瘤影,分別位于前交通動(dòng)脈處(2例)、右側(cè)大腦中動(dòng)脈水平段遠(yuǎn)端分叉處(2例)、左側(cè)大腦中動(dòng)脈水平段遠(yuǎn)端分叉處(1例)。1例左側(cè)頸內(nèi)-后交通動(dòng)脈瘤夾閉術(shù)后載瘤動(dòng)脈閉塞,CTA表現(xiàn)為相應(yīng)節(jié)段的動(dòng)脈未見(jiàn)顯影。結(jié)論 64層MSCTA能清晰顯示顱內(nèi)動(dòng)脈瘤術(shù)后鈦合金瘤夾的位置與形態(tài)、載瘤動(dòng)脈的通暢情況以及夾閉不全時(shí)殘存的動(dòng)脈瘤。
[Abstract]:Objective to evaluate the CT angiography (CTAA) findings of clipping insufficiency and aneurysm carrying artery occlusion after intracranial aneurysm operation, and to analyze the possible causes of clipping insufficiency and aneurysm carrier artery occlusion.Methods the CTA data of 118 patients after intracranial aneurysm clipping were retrospectively analyzed. The post-processing techniques of 64-slice spiral CT scan, multiplanar recombination MPRA, maximum density projection and volumetric reconstruction were used, and compared with digital angiography (DSA).To evaluate the CTA features of the aneurysm carrier artery, especially the location of the tumor clamp, and the shape of the residual tumor if the clamping was unsuccessful.Results there were 6 cases of aneurysm patency and 1 case of aneurysm occlusion confirmed by DSA in 5 cases.All titanium clips show clear, no artifacts.On CTA, aneurysm clipping was characterized by the presence of small nodules, cones, vesicles or pouch aneurysms around the aneurysm clamp.Two cases were located at the anterior communicating artery, two cases were located at the distal bifurcation of the horizontal segment of the right middle cerebral artery, and one case was located at the distal branch of the horizontal segment of the left middle cerebral artery in 1 case. 1 case was located in the left internal and posterior communicating artery aneurysm clipped after clipping the aneurysm of the left internal and posterior communicating artery.CTA showed no development of the corresponding segment of artery.Conclusion 64-slice MSCTA can clearly show the location and shape of titanium alloy clamp, patency of aneurysm carrier artery and occlusion of incomplete aneurysms after intracranial aneurysm operation.
【作者單位】： 湖北省襄陽(yáng)市中心醫(yī)院(湖北文理學(xué)院附屬醫(yī))放射影像科;華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬協(xié)和醫(yī)院放射科;
【分類號(hào)】：R651.12;R816.1

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