影像融合技术在颅内多发动脉瘤破裂出血后责任动脉瘤判断中的应用

目的 探讨影像融合技术在颅内多发动脉瘤破裂出血后责任动脉瘤判断中应用效果。方法 2016年1月至2020年8月前瞻性收治颅内多发动脉瘤破裂出血57例，术前将CT及CTA扫描DICOM格式原始数据导入3D Slicer软件进行影像融合，判断出血责任动脉瘤，并与开颅手术记录进行对比。结果 融合影像可以精确地显示蛛网膜下腔血肿与动脉瘤的关系。57例中，54例（94.7%）融合影像判断责任动脉瘤与手术记录一致，3例不一致（1例出血量小、2例出血量过多，无法根据血肿与动脉瘤的空间关系判定责任动脉瘤）。结论 颅内多发动脉瘤破裂出血病人，应用3D Slicer软件将CT与CTA数据进行影像融合，可以精确显示血肿与动脉瘤的空间关系，有助于判断破裂出血的责任动脉瘤。

Application of fusion imaging of CT and CTA using 3D Slicer software to determine the ruptured aneurysm in patients with multiple intracranial aneurysms after acute aneurysmal subarachnoid hemorrhage

Objective To investigate the application value of image fusion techniques in the diagnosis of responsible aneurysms for subarachnoid hemorrhage (SAH) in patients with multiple intracranial aneurysms (MIA). Methods Fifty-seven patients with MIA who suffered from SAH were prospectively recruited from January 2016 to August 2020. The original data of CT and CTA scanning in DICOM format were imputted into a 3D Slicer software for image fusion before surgery to determine the responsible aneurysms for SAH, and the clipping records were used as the diagnostic gold standard of the responsible aneurysms for SAH. Results Fusion images could accurately show the relationship between subarachnoid hematoma and aneurysms. The responsible aneurysms for SAH were found to be consistent with the surgical records by fusion imaging in 54 patients (94.7%), and inconsistent in 3 patients (light SAH in 1 patient and heavy SAH in 2 patients, making it impossible to determine the responsible aneurysm according to the spatial relationship between hematoma and aneurysm). Conclusions For patients with MIA after SAH, fusion images of CT and CTA using a 3D Slicer software can accurately show the spatial relationship between hematoma and aneurysm, and help determine the responsible aneurysm for SAH.