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The Feasible Analysis of MRA for a Follow-up Visit after Embolization of Intracranial Aneurysms

Author: FuZuo
Tutor: ZhangJian
School: Dalian Medical University
Course: Neurosurgery
Keywords: Endovascular treatment MRI Revisit
CLC: R651.1
Type: Master's thesis
Year: 2011
Downloads: 2
Quote: 0
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Abstract


Objective: The goal treated technical and the material development along with the blood vessel, in the blood vessel embolism treats already became important means which the aneurism treated. In the blood vessel embolism treats the encephalic aneurism, has does not need the skull, to damage slightly to the patient nerve function, micro creates and so on merits. In some overseas large amount case’s forward-looking research, contrasts the skull to clamp shuts the effect which treats with the blood vessel, finally discovered that both may effective prevent aneurism’s again breakage hemorrhage, but in the blood vessel treats the mortality rate and crippling rate is smaller than obviously the skull clamps shuts. But, in the blood vessel treats although short-term effect good, but after patient technique, needs the regular cerebral angiography revisit, the long-term effect is not explicit, some literature report, after the encephalic aneurism embolism technique’s recurrence rate reaches as high as 20.9%~47.4%. It is well known, after the digit reduces the shade angiography (digital subtraction angiography, DSA) is the encephalic aneurism diagnosis as well as embolism technique, makes a follow-up visit golden standard, but DSA is one kind of risk is big, has the wound, the expense high inspection, at present requests the encephalic aneurism embolism latter 3 months to carry on DSA generally to during 3 years the inspection, understood that the aneurism embolism’s degree, whether there does recur, spring coil whether bearing shifting, whether there is the essential further good embolism to treat. Therefore, seeks for one kind accurately both the inspection method which, and damages has the clinical value. The magnetic resonance angiography (magnetic resonance angiography, MRA) is one common blood vessel image formation method. This experiment’s goal is, through MRA and DSA contrast, to MRA after encephalic aneurism embolism technique makes a follow-up visit the feasibility to carry on the analysis and the appraisal.Methods: May escape the spring coil to 55 good electrolyses (GDC) embolism’s encephalic aneurism patient line of MRA and the DSA revisit, the revisit time for the technique latter three months, DSA and the MRA inspection time interval most length is one week. Take DSA as the revisit standard, compared with both’s revisit result, counts the MRA revisit the false negative and the false positive integer, through statistics analysis, whether there is monitors both’s statistics difference, thus appraises the MRA revisit the accuracy.Results: 55 aneurism patient altogether 60 aneurisms carried on the aneurism blood vessel embolism to treat, the DSA revisit discovered 45 aneurism complete embolism, 10 aneurism neck residual contrast medium, 5 aneurism body residual contrast medium. But the MRA revisit only discovered that 2 false negative and 2 false positive result, the rate of accuracy is 93.3%. Two kind of inspection method good consistency check, the K value is 0.839; Parallel chi-square test, x2=97.23, P<0.05..Conclusion: Applies MRA through this experiment after 60 example encephalic aneurism blood vessel in embolism iatrotechnics carries on the revisit the effect, after MRA is the encephalic aneurism embolism technique one kind credible, does not have the wound, the fast phantom revisit method, after encephalic aneurism blood vessel embolism technique makes a follow-up visit the value is worth affirmative, can the basic accurate appraisal aneurism embolism’s situation, after the aneurism embolism technique made a follow-up visit has provided one kind of unreliability, not created inspection method. We believed that will develop and the more phantom software’s development unceasingly along with the later magnetic resonance phantom technology, MRA after the encephalic aneurism embolism technique will make a follow-up visit displays a greater value, will substitute for DSA to become the revisit gradually the first choice method.

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CLC: > Medicine, health > Surgery > Of surgery > Head and Neurosurgery > Brain
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