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目的 探讨旋转DSA三维重建成像 (3DDSA)在颈动脉狭窄诊断及治疗中的价值 ,并与常规DSA(2DDSA)进行比较。方法 对 2DDSA证实的 4 2例患者 5 0条狭窄颈动脉分别进行旋转血管造影和DSA三维成像后处理 ,对其中 19例患者进行内支架成形术及术后 2DDSA和 3DDSA检查。由工作经验丰富的 2位阅片者采用双盲法对 2DDSA和 3DDSA的图像进行分析与测量 ,并计算出血管的直径狭窄率和面积狭窄率。通过仿真血管内镜 (virtualangioscopy ,VA)观察血管内表面斑块的情况。结果 3DDSA与 2DDSA测量颈动脉狭窄的直径狭窄率比较差异无统计学意义 (P >0 0 5 ) ;3DDSA测量的面积狭窄率约 6 8%明显高于 3D及 2DDSA测量的直径狭窄率 P <0 0 1) ,按面积狭窄率对血管狭窄程度进行分级也多数比按直径狭窄率严重 ;3DDSA显示 34条血管存在斑块 ,而 2DDSA仅显示 6条 (P <0 0 0 5 ) ;3D与 2DDSA判断内支架术后狭窄改善情况相比较差异有统计学意义 (P <0 0 5 )。结论 3DDSA判断颈动脉狭窄的准确性优于 2DDSA ,能为颈动脉狭窄的诊断与治疗以及评价疗效提供更丰富的有用信息。
Objective To investigate the value of 3D DSA in the diagnosis and treatment of carotid artery stenosis and to compare with conventional DSA (2D DSA). Methods Rotational angiography and 3D reconstruction of DSA were performed in 40 patients with 2DDSA confirmed 40 carotid stenosis. Nineteen patients underwent stent and postoperative 2D DSA and 3DDSA examinations. The two experienced readers used the double-blind method to analyze and measure the images of 2DDSA and 3DDSA, and calculated the diameter stenosis rate and area stenosis rate. Vasculo-plaque was observed by virtual endoscopy (VA). Results The diameter stenosis rates of 3DDSA and 2DDSA were not statistically different (P> 0.05). The area stenosis rate of 3DDSA was 68%, which was significantly higher than that of 3D and 2D DSA 0 1). According to the stenosis rate, most of the patients were graded according to the stenosis rate. 3DDSA showed plaque in 34 vessels, but only 6 showed 2DDSA (P <0 055). 3D and 2DDSA There was significant difference between the two groups (P <0.05). Conclusion 3DDSA is superior to 2DDSA in determining the accuracy of carotid artery stenosis. It can provide more useful and useful information for the diagnosis and treatment of carotid stenosis.