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Dimensional DSA in the diagnosis and treatment of intracranial aneurysms Application

Author: GouLiYun
Tutor: ZhaoWei
School: Kunming Medical College
Course: Medical Imaging
Keywords: 3D-DSA Imaging modalities Intracranial aneurysms Diagnosis Treatment
CLC: R743.35
Type: Master's thesis
Year: 2011
Downloads: 52
Quote: 0
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Abstract


Objective: three-dimensional digital subtraction angiography (three dimensional digital subtraction angiography, 3D-DSA), the diagnosis of intracranial aneurysms, a detailed understanding of the anatomic features of intracranial aneurysms and hemodynamic changes, through the digital tablet detectors of various common imaging mode DSA comparative analysis aimed at rational and effective use of digital flat panel detector DSA various imaging modes of intracranial aneurysms accurate diagnosis and assessment, select the appropriate treatment and therapy guidance . For appropriate interventional embolization of intracranial aneurysms, study how to use a variety of imaging mode characteristics of the aneurysm size and aneurysm accurate measurement, how reasonable choice embolization methods and work posture; embolization treatment, How to use a variety of reasonable road map to reduce the difficulty of treatment, as well as how to effectively determine the extent of embolization; review after embolization, how sharper display with or without aneurysm recurrence and determine whether a re-embolization. Materials and Methods: March 2009 to February 2011 in our hospital suspected intracranial aneurysms underwent 3D-DSA inspections of 32 patients were detected in 38 aneurysms, brain CT demonstrated subarachnoid hemorrhage 32 cases; 38 aneurysms were made endovascular treatment, 32 patients were at about 6 months after embolization line 3D-DSA review by three or more neurological interventional physicians (at least two senior positions) read together pieces to make a diagnosis, understanding whether aneurysm recurrence after embolization, if necessary, re-line endovascular treatment. In both experiments to simulate the location of intracranial aneurysms and measurement methods to study how the use of various imaging modes characteristics, size of aneurysm and parent artery for accurate measurement. All patients with 3D digital flat panel detector rows and lateral and rotational DSA examination, rotational DSA collected data to the workstation for processing. Try using the processed image on a variety of imaging for diagnosis of intracranial aneurysms and evaluation; For decision for endovascular embolization of aneurysms, a reasonable choice embolization methods and work posture; embolization process, encountered branch vessels over more accurate selection intubation, how to effectively use various road map to reduce intubation difficulty; and how to select the appropriate subtraction chart to determine the extent of embolization; review after embolization, researchers use what mode of imaging map to clearly show the presence or absence of recurrence and to determine whether a re-embolization. Results: 1, conventional 2D-DSA for accurate diagnosis of intracranial aneurysms significantly less rotational DSA and 3D-DSA variety of common-mode image, and 3D-DSA images and a variety of common patterns rotational DSA images of intracranial aneurysms indeed accurate diagnosis almost no significant difference. 2, in the 2D image, take in the view of the detector as close as possible to the catheter intracranial aneurysms way to reduce measurement error; 3D reconstructed images were measured after treatment of intracranial aneurysms, the resulting measurement error is small. 3,3 D reconstructed image of a variety of common mode imaging and rotational DSA image of the aneurysm and the spatial relationship of aneurysm, aneurysm neck, aneurysm wall display case and the availability of small artery branches was significantly higher than 2D-DSA images, but rotational DSA and 2D-DSA showed good hemodynamic conditions, and can dynamically display intravascular blood flow within the aneurysm, is conducive to embolization of intracranial aneurysm embolization therapy and after review. 4,26 aneurysms 2D image and 3D image reconstruction of rotational DSA images showed dense embolization, follow-up without recurrence; 6 aneurysm embolization dense 2D image display, while the rotational DSA images, 3D reconstruction image shows up there is not dense embolism a relapse; 6 aneurysms 2D images, 3D rotational DSA images and reconstruction images showed a residual aneurysm neck up with a recurrence. Conclusion: According to the diagnosis of intracranial aneurysms, embolization, and after review of the different circumstances, reasonable and effective application of 3D digital flat panel detector DSA various imaging modalities, to improve the accurate diagnosis of intracranial aneurysms rate and improve the embolization intracranial aneurysms technical level, to reduce the incidence of complications and reduce the recurrence rate purposes.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke) > Subarachnoid hemorrhage
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