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目的探讨静脉法三维数字减影血管成像(intravenous three-dimensional digital subtraction angiography,IV3D DSA)在脑血管中运用的临床可行性,并与容积CT数字减影血管成像(VCTDSA)对照评价其图像质量。方法对21例行VCTDSA的动脉瘤开颅夹闭术后患者同期行IV 3D DSA脑血管成像检查。对比剂从肘前静脉入路,行头部3D DSA,将原始数据传至工作站进行后处理。结果 IV 3D DSA检查中,2例失败,19例成功,20个动脉瘤夹均显示较清晰(其中1例有2个动脉瘤夹),12例清晰显示动脉瘤夹闭完全,载瘤动脉通畅,7例因运动伪影干扰使载瘤动脉显示欠佳,大部分能较好地显示颅内主要大动脉,其中,图像质量Ⅱ级占10.5%(2/19),Ⅲ级占84.2%(16/19),Ⅳ级占5.3%(1/19);对应VCTDSA中,19例动脉瘤夹及载瘤动脉均清晰显示,图像质量Ⅰ级占36.8%(7/19),Ⅱ级占42.1%(8/19),Ⅲ级占21.1%(4/19)。IV 3D DSA与VCTDSA的图像质量差异有统计学意义(Z=-3.782,P<0.05)。结论 IV 3D DSA临床可行,但图像质量不及VCTDSA。IV 3D DSA尚需优化成像参数提高图像质量。
Objective To investigate the clinical feasibility of intravenous three-dimensional digital subtraction angiography (IV3D DSA) in cerebrovascular disease and to evaluate its image quality in comparison with volume CT digital subtraction angiography (VCTDSA). Methods A total of 21 VCTDSA aneurysm patients underwent cranial craniotomy for IVD DSA cerebrovascular imaging. Contrast agent from the antecubital vein access line head 3D DSA, the raw data transmitted to the workstation for post-processing. Results In the 3D 3D DSA examination, 2 cases failed, 19 cases were successful, and 20 aneurysm clips were clearer (1 of them had 2 aneurysm clips). In 12 cases, the aneurysm was completely closed and the parent artery was smooth , Most of them showed the main intracranial arteries satisfactorily. Among them, the image quality grade Ⅱ accounted for 10.5% (2/19), the grade Ⅲ accounted for 84.2% (16 / 19), grade IV accounted for 5.3% (1/19). Corresponding VCTDSA, 19 aneurysm clips and the parent artery clearly showed that the image quality grade Ⅰ accounted for 36.8% (7/19), Ⅱ grade accounted for 42.1% (8/19), grade Ⅲ accounted for 21.1% (4/19). The image quality of IV 3D DSA and VCTDSA was statistically different (Z = -3.782, P <0.05). Conclusion IV 3D DSA is clinically feasible, but its image quality is inferior to that of VCTDSA. IV 3D DSA still need to optimize the imaging parameters to improve image quality.