弹簧圈栓塞颅内动脉瘤的远期MRA随访研究
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国家“十一五”科技攻关项目(延续资助)(001BA70316)


Long term follow up of coiled intracranial aneurysms by MR angiography
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    摘要:

    目的:探讨磁共振血管成像(MRA)在颅内动脉瘤弹簧圈栓塞后远期随访的可行性-方法:应用3D时间飞跃法MRA (3D TOF-MRA)对38例患者用弹簧圈栓塞3年以上的38个颅内动脉瘤进行扫描,并同期进行数字减影血管造影(DSA)检查-以DSA结果为标准,对MRA图像显示的动脉瘤的残留及载瘤动脉通畅情况进行分析-结果:38个动脉瘤中,DSA证实稳定33个,复发5个,载瘤动脉通畅36例,闭塞2例;MRA发现动脉瘤稳定32个,复发6个,载瘤动脉通畅34例,闭塞4例-MRA判断动脉瘤残留的敏感度-特异度分别为84.6%-92.0%;判断动脉瘤复发的敏感度-特异度分别为80.0%-93.0%;判断载瘤动脉是否通畅的敏感度-特异度分别为94.4%-100%-结论:3D TOF MRA是长期随访栓塞后颅内动脉瘤的有效-可靠的方法,但需进一步积累经验-

    Abstract:

    Objective:To evaluate the feasibility and usefulness of 3D time of flight MR angiography(TOF-MRA) for the follow-up of intracranial aneurysms treated with guglielmi detachable coils. Methods:Total of 38 patients with 38 aneurysms treated with guglielmi detachable coils over 36 months were examed by 3D TOF-MRA and DSA simultaneously. DSA was the reference for the detection of a residual neck or residual aneurysm. Recurrence of aneurysms and patency of parent arteries were determined by comparing MRA with DSA. Results:In 38 aneurysms,DSA found that 33 cases were stable,and 5 were recurrent. Meanwhile,36 parent arteries were patent,and the others were occluded by DSA. MRA found that 32 were stable,and 6 were recurrent,and 34 parent arteries were patent,and 4 were occluded. The sensitive and specificity to diagnose residual flow by MRA were 84.6% and 92.0%,respectively;the sensitive and specificity of MRA to diagnose recurrence were 80.0% and 93.0%,respectively;the sensitive and specificity of MRA to diagnose that whether parent arteries is patent or not were 94.4% and 100%,respectively. Conclusions:3D TOF-MRA is efficient and reliable for the long term follow-up of intracranial aneurysms. Moreover,further experimental evidence of MRA is needed.

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卢小健,张鸿祺,张〓鹏,支兴龙,凌〓锋.弹簧圈栓塞颅内动脉瘤的远期MRA随访研究[J].南京医科大学学报(自然科学版),2010,(2):206-210

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