ĐÁNH GIÁ THAY ĐỔI LƯU LƯỢNG DÒNG CHẢY TRONG TÚI PHÌNH ĐỘNG MẠCH NÃO SAU ĐẶT STENT ĐỔI HƯỚNG DÒNG CHẢY TRÊN ANEURYSMFLOWTM=Blood flow alterations after flow diverter placement using the AneurysmflowTM tool

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Tác giả: Chí Công Lê, Hoàng Kiên Lê, Hữu An Nguyễn, Quang Anh Nguyễn, Tất Thiện Nguyễn, Thị Thu Trang Nguyễn, Anh Tuấn Trần, Trần Cường Trần, Xuân Bách Trần, Đăng Lưu Vũ

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.59-66

Bộ sưu tập: Báo, Tạp chí

ID: 487023

Thêm vào giỏ

Mục tiêu: Sử dụng phần mềm AneurysmFlow (Philips Healthcare) trên máy DSA để khảo sát sự thay đổi dòng chảy trong túi phình sau điều trị đổi hướng dòng chảy.Đối tượng và phương pháp: 18 bệnh nhân có túi phình ĐM não hình túi chưa vỡ được điều trị bằng stent đổi hướng dòng chảy tại Trung tâm Điện quang, Bệnh viện Bạch Mai. Đầu tiên, tiến hành chụp mạch 3D túi phình. Sau đó chụp khung hình tốc độ cao trước và sau khi đặt stent với lượng thuốc cản quang được tiêm 1,5 ml / s trong 4 giây. Lưu lượng dòng chảy trong túi phình được tính trước - sau điều trị trên mỗi bệnh nhân.Kết quả: Lưu lượng trong TP giảm có ý nhĩa sau đặt stent đổi hướng dòng chảy (p=0.001 <
0.05), trung bình giảm khoảng 19.51%. Tuy nhiên có 4 TP (21.05%) có lưu lượng tăng lên sau khi đặt stent. Ngoài ra mức độ dao động vận tốc dòng chảy trong túi phình mạch não so với ĐM mang cũng được ghi nhận. Mức độ % thay đổi lưu lượng trong TP sau can thiệp không có sự khác biệt theo các nhóm kích thước (nhóm TP lớn và trung bình, p = 0.612) và hình thái TP (nhóm TP bờ nhẵn và bờ không đều, thùy múi, có núm, 2 đáy
p = 0.625). Tỉ số MAFA trong nghiên cứu rất dao động và đa số nhỏ hơn 1, tuy nhiên tất cả các TP trong nghiên cứu đều tắc hoàn toàn ở thời điểm 6 tháng sau can thiệp.Kết luận: Phần lớn các túi phình có lưu lượng giảm sau đặt stent đổi hướng dòng chảy. Không có sự khác biệt về mức độ giảm lưu lượng trong túi phình sau can thiệp theo kích thước và hình thái túi phình.Purpose: We used AneurysmFlow software (Philips Healthcare) on DSA to analyze flow characteristics in aneurysms after Flow Diverter Stent (FDS) treatment.Methods: 18 patients with unruptured cerebral aneurysms were treated for FDS at the Bach Mai Radiology Center. First, a 3D rotational angiogram of the aneurysm was acquired. Then, two high frame rate DSA sequences were acquired before and right after the implantation of the FDS with a contrast injection of 1.5 ml/sec for a duration of 4s. The aneurysmal flow was calculated before - after the implantation of the FDS for each patient.Results: The aneurysmal flow was significantly reduced after implantation of the FDS (p=0.001 <
0.05), the mean reduction was about 19.51%. However, 4 aneurysms (21.05%) had increased flow after treatment. The pulsatility of aneurysmal flow is reduced after the insertion of the flow diverter. This reduction of the aneurysmal flow does not differ by aneurysm size (large and medium aneurysm, p = 0.612) and aneurysm morphology (smooth and irregular, lobe, knob, bilobar
p = 0.625). The MAFA ratio in the study is variable and mostly was less than 1, but all aneurysms in the study were complete obliteration at 6 months after the intervention.Conclusion: Significant reductions in flow inside the aneurysm were observed after implantation of the FDS. There was no difference in the reduction of aneurysmal flow after intervention according to aneurysm size and morphology.

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