[1]李自恒,赵 卫,杨 凯,等.不同对比剂稀释浓度在颅内支架高分辨率C形臂CT成像中的应用[J].介入放射学杂志,2022,31(02):125-129.
 LI Ziheng,ZHAO Wei,YANG Kai,et al.The application of different concentrations of contrast medium in high-resolution C-arm CT imaging of intracranial stents[J].journal interventional radiology,2022,31(02):125-129.
点击复制

不同对比剂稀释浓度在颅内支架高分辨率C形臂CT成像中的应用()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
31
期数:
2022年02
页码:
125-129
栏目:
神经介入
出版日期:
2022-02-25

文章信息/Info

Title:
The application of different concentrations of contrast medium in high-resolution C-arm CT imaging of intracranial stents
作者:
李自恒 赵 卫 杨 凯 张晓东 孟雪柔 李玉婷 王 滔
Author(s):
LI Ziheng ZHAO Wei YANG Kai ZHANG Xiaodong MENG Xuerou LI Yuting WANG Tao.
Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China
关键词:
【关键词】 C形臂CT 血流导向装置 颅内动脉瘤 对比剂
文献标志码:
A
摘要:
【摘要】 目的 探讨注射不同稀释浓度对比剂的高分辨率C形臂CT在Pipeline Flex植入术中的应用。方法 回顾性分析2019年1月至2021年1月在昆明医科大学第一附属医院接受Pipeline Flex植入治疗的25例颅内动脉瘤患者临床资料,其中术中接受高分辨率C形臂CT检查时对比剂稀释比例为10%患者12例(A组),稀释比例为15%患者13例(B组)。3名神经介入专家对两组患者影像的支架释放、支架与动脉瘤空间关系、支架贴壁情况进行客观评价并予定性评分,再采用ImageJ软件客观记录载瘤动脉灰度值和背景灰度值,以比值代表支架与载瘤动脉腔对比度并予定量分析。记录患者术中术后相关并发症。结果 25例患者共成功植入25枚Pipeline Flex。影像质量定性评分和定量分析结果显示,A、B组支架释放、支架与动脉瘤空间位置显示差异均无统计学意义(P>0.05);支架贴壁显示差异有统计学意义,B组优于A组(P<0.05)。所有患者均获随访6~12个月,平均(8.6±2.5)个月,复查显示O’Kelly-Marotta(OKM)分级A级0例,B级1例(4%),C级5例(20%),D级19例(76%),动脉瘤完全闭塞率为76%;均未出现支架移位、出血等不良事件。结论 通过ImageJ软件在主观定性评分基础上进行客观定量评价,颈内动脉颅内段动脉瘤因有骨组织重叠,对比剂稀释程度为15%左右较好,而大脑前动脉和大脑中动脉动脉瘤使用10%稀释比例,即可满足临床需求。

参考文献/References:

[1] Becske T, Brinjikji W, Potts MB, et al. Long- term clinical and angiographic outcomes following pipeline embolization device treatment of complex internal carotid artery aneurysms: five- year results of the pipeline for uncoilable or failed aneurysms trial[J]. Neurosurgery, 2017, 80: 40- 48.
[2] Ravindran K, Salem MM, Enriquez- Marulanda A, et al. Quan- titative assessment of in- stent stenosis after pipeline embolization device treatment of intracranial aneurysms:a single- institution series and systematic review[J]. World Neurosurg, 2018, 120: e1031- e1040.
[3] Li TF, Ma J, Han XW, et al. Application of High- resolution C- arm CT combined with streak metal artifact removal technology for the stent- assisted embolization of intracranial aneurysms[J]. AJNR Am J Neuroradiol, 2019, 40: 1752- 1758.
[4] 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, 54:641- 645.
[5] 王 凯,成晓江,卡合尔曼?卡德尔,等. Pipeline Flex血流导向装置治疗颅内动脉瘤的初步临床经验[J]. 中华神经外科杂志, 2019, 35:547- 551.
[6] Rajah G, Narayanan S, Rangel- Castilla L. Update on flow diverters for the endovascular management of cerebral aneurysms[J]. Neurosurg Focus, 2017, 42: E2.
[7] 卢 昊,胡 鹏,张鸿祺,等. Pipeline栓塞装置治疗颅内未破裂动脉瘤的短期疗效[J]. 中华神经外科杂志, 2017, 33:785- 789.
[8] Zhang H, Gao X, Liang H, et al. Incomplete stent apposition of low- profile visualized intraluminal support stents in the treatment of cerebral aneurysms[J]. J Neurointerv Surg, 2020, 12: 591- 597.
[9] Aquarius R, de Korte A, Smits D, et al. The importance of wall apposition in flow diverters[J]. Neurosurgery, 2019, 84: 804- 810.
[10] Altes TA, Cloft HJ, Short JG, et al. 1999 ARRS Executive Council Award. Creation of saccular aneurysms in the rabbit: a model suitable for testing endovascular devices. American Roentgen Ray Society[J]. AJR Am J Roentgenol, 2000, 174: 349- 354.
[11] 陈 蓦,王 武. 颅内动脉瘤血管内治疗现状与进展[J]. 介入放射学杂志, 2018, 27:592- 597.
[12] Caroff J, Mihalea C, Neki H, et al. Role of C- arm VasoCT in the use of endovascular WEB flow disruption in intracranial aneurysm treatment[J]. AJNR Am J Neumradiol, 2014, 35: 1353- 1357.
[13] Patel NV, Gounis MJ, Wakhloo AK, et al. Contrast- enhanced angiographic cone- beam CT of cerebrovascular stents: experimental optimization and clinical application[J]. AJNR Am J Neuroradiol, 2011, 32: 137- 144.

相似文献/References:

[1]杨鹏飞,刘建民,黄清海,等.新型血流导向装置Tubridge治疗颅内动脉瘤的初步经验[J].介入放射学杂志,2011,(05):357.
 YANG Pengfei,LIU Jianmin,HUANG Qinghai,et al.The use of novel flow diverting device Tubridge for the treatment of intracranial aneurysms: initial experience[J].journal interventional radiology,2011,(02):357.
[2]蒋春雨,王建波. 血流导向装置在颅内动脉瘤介入治疗中的应用[J].介入放射学杂志,2014,(03):267.
 JIANG Chun? yu,WANG jian? bo.. The application of flow diverter stent in treating intracranial aneurysms[J].journal interventional radiology,2014,(02):267.
[3]李 航,李天晓,白卫星,等.颅内巨大动脉瘤血流导向装置治疗术后再破裂出血1例[J].介入放射学杂志,2017,(06):507.
 LI Hang,LI Tianxiao,BAI Weixing,et al.Rupture with bleeding of giant intracranial aneurysm occurring after flow diversion therapy: report of one case[J].journal interventional radiology,2017,(02):507.
[4]朱 涛,李 晓,吕丽红,等.高分辨率C形臂CT联合金属条纹伪影消除技术在颅内动脉瘤支架辅助栓塞中的应用 [J].介入放射学杂志,2019,28(09):826.
 ZHU Tao,LI Xiao,Lv Lihong,et al.Clinical application of high- resolution C- arm CT scanning combined with streak metal artifact removal technology in stent- assisted embolization of intracranial aneurysms[J].journal interventional radiology,2019,28(02):826.
[5]李 航,白卫星,贺迎坤,等.PipelineTM栓塞装置治疗颅内动脉瘤术后并发症研究进展 [J].介入放射学杂志,2017,(08):760.
 LI Hang,BAI Weixing,HE Yingkun,et al.Progress in study on Pipline embolization device treatment for postoperative complications of intracranial aneurysm[J].journal interventional radiology,2017,(02):760.
[6]杨 凯,王 滔,李 彬,等.高分辨率C形臂CT在颅内动脉瘤Pipeline Flex植入术中的价值 [J].介入放射学杂志,2021,30(06):544.
 YANG Kai,WANG Tao,LI Bing,et al.The application value of high-resolution C-arm CT in performing Pipeline Flex embolization device implantation for intracranial aneurysms[J].journal interventional radiology,2021,30(02):544.
[7]张学贤,杨 凯,赵 卫,等.血流导向装置治疗颅内动脉瘤后覆盖分支通畅性研究进展[J].介入放射学杂志,2021,30(10):1061.
 ZHANG Xuexian,YANG Kai,ZHAO Wei,et al.The patency of covered side branches of intracranial aneurysms after flow-diverter treatment: recent progress in research[J].journal interventional radiology,2021,30(02):1061.
[8]宋稳鹏,白京岳,孟庆斌,等.血流导向装置与传统血管内重建治疗椎动脉夹层动脉瘤对比研究[J].介入放射学杂志,2022,31(06):545.
 SONG Wenpeng,BAI Jingyue,MENG Qingbin,et al.Flow diverter device versus traditional endovascular reconstruction for vertebral dissecting aneurysms: a comparative study[J].journal interventional radiology,2022,31(02):545.
[9]杨 震,郭新宾,邓 鑫,等.血流导向装置在后循环夹层动脉瘤的应用[J].介入放射学杂志,2022,31(08):751.
 YANG Zhen,GUO Xinbin,DENG Xin,et al.Application of flow diverter in treating posterior circulation dissecting aneurysms[J].journal interventional radiology,2022,31(02):751.
[10]徐李刚,万 军,张 磊,等.国产Tubridge血流导向装置治疗中小型颅内动脉瘤的短期疗效及安全性分析[J].介入放射学杂志,2023,32(05):421.
 XU Ligang,WAN Jun,ZHANG Lei,et al.Domestic Tubridge flow diverter for the treatment of small and medium-sized intracranial aneurysms: analysis of its short-term efficacy and safety[J].journal interventional radiology,2023,32(02):421.

备注/Memo

备注/Memo:
(收稿日期:2021- 03- 10)
(本文编辑:边 佶)
更新日期/Last Update: 2022-02-21