CPR技术在颅内血流导向装置植入术中的应用

doi:10.3877/cma.j.issn.2095-5782.2023.03.009

目的

探索曲面重建技术（curved plannar reconstruction，CPR）在颅内血流导向装置植入术中的应用价值。

方法

选取我院神经介入科采用血流导向装置治疗颅内动脉瘤的20例患者，术中使用锥体束CT（cone beam computed tomography，CBCT）稀释造影，分别使用最大密度投影技术（maximal intensity projection，MIP）和CPR两种算法重建图像评估血流导向装置贴壁情况。由3位神经介入科医师采用VAS（visual analogue scale）盲法评分，比较两种技术重建图像的质量。

结果

血流导向装置植入术中CBCT扫描后采用CPR技术处理VAS评分为（4.49 ± 0.35），采用MIP技术处理VAS评分为（2.03 ± 0.43），P值为0.000 1，差异有统计学意义。

结论

在血流导向装置植入术中CBCT稀释造影，CPR重建图像质量优于MIP，更有利于观察血流导向装置贴壁情况。

关键词: 颅内动脉瘤, 血流导向装置, CBCT, CPR, MIP

Objective

To explore the application value of Curved Plannar Reconstruction (CPR) in cone beam computed tomography (CBCT) of cerebral aneurysm after blood flow diverter device implantation.

Methods

Twenty patients after interventional blood flow diverter device implantation were selected and scanned by CBCT dilution angiography during operation.The maximum intensity projection (MIP) and curved CPR were used to reconstruct images to evaluate the adherence of the blood flow diverter device. Three neurologists from the interventional department used VAS (Visual Analogue Scale) blind scoring method to compare the quality of the reconstructed images of the two techniques.

Results

During the implantation of blood flow diverter device, after CBCT scanning, the VAS score of CPR was 4.49 ± 0.35, and that of MIP was 2.03 ± 0.43, P = 0.000 1, which indicate the difference was statistically significant.

Conclusions

After CBCT dilution angiography during blood flow diverter device implantation, the image quality of CPR reconstruction is better than that of MIP, which is more suitable for observing the adherence of blood flow diverter device.

Key words: Cerebral aneurysm, Flow diverter, CBCT, CPR, MIP

图1 分别通过CPR和MIP重建后的图像评估血流导向装置贴壁情况1A：患者Ⅰ颅内动脉瘤血流导向装置植入术后CPR重建图像可以清晰显示支架贴壁不良和血管间隙（红色箭头）；1B：患者Ⅱ颅内血流导向装置植入术后CPR重建图像可以清晰显示支架贴壁不良和血管间隙（红色箭头）；1C：患者Ⅰ MIP重建后支架贴壁情况显示较模糊（红色箭头）；1D：患者Ⅱ MIP重建后支架贴壁情况显示较模糊（红色箭头）。

图2 VAS评分t检验视图

表1 不同重建算法显示血流导向装置VAS评分比较

变量	例数（例）	±s	t值	P值
CPR组	20	4.49 ± 0.35	14.69	0.000 1
MIP组	20	2.03 ± 0.43

表1 不同重建算法显示血流导向装置VAS评分比较

变量	例数（例）	±s	t值	P值
CPR组	20	4.49 ± 0.35	14.69	0.000 1
MIP组	20	2.03 ± 0.43

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Application of CPR technique in intracranial blood flow diverter device implantation

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Application of CPR technique in intracranial blood flow diverter device implantation