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研究背景通过综合分析颈静脉孔区颅内静脉窦血管造影术影像学表现,探讨颅内静脉窦支架植入困难或失败原因,并寻找可预测静脉窦狭窄支架植入困难的临床指标,以提高手术成功率。方法对118例接受颅内静脉窦支架植入术患者(窦狭窄伴颅内高压87例、窦狭窄致搏动性耳鸣31例)的临床资料进行回顾,分析颈静脉孔区静脉窦两个转折夹角及静脉窦直径对支架植入技术成功的影响。结果共115例患者术中支架植入成功、3例因支架植入困难而导致手术失败。颈静脉孔区静脉窦为连接乙状窦和颈内静脉的过渡结构,侧位脑血管造影呈典型“N”形结构,支架植入成功者静脉窦两个转折夹角之和为(120.11±30.32)°、失败者为(86.37±10.72)°,二者差异有统计学意义(t=23.420,P=0.001);静脉窦直径分别为(5.10±1.12)和(5.11±0.37)mm,差异无统计学意义(t=7.210,P=0.352)。结论颈静脉孔区静脉窦侧位脑血管造影呈“N”形结构,若静脉窦两转折夹角过小易导致支架植入困难,但静脉窦直径不影响支架的植入。
Background of the study Through comprehensive analysis of imaging findings of cranial venous sinus angiography in jugular foramen region, the reasons for difficulty or failure of intracranial sinus stent implantation were explored, and the clinical indexes for predicting the implantation difficulties of sinus stenosis stent were searched to improve Surgical success rate. Methods The clinical data of 118 patients who underwent intracranial venous sinus stenting (87 cases of sinus stenosis with intracranial hypertension and 31 cases of sinus pacing-induced tinnitus) were retrospectively analyzed. Angle and sinus diameter on stent implantation success. Results A total of 115 cases were successfully treated with intraoperative stent implantation and 3 cases with unsuccessful stent implantation. The jugular foramen venous sinus is a transitional structure connecting the sigmoid sinus and the jugular vein. The lateral cerebral angiography showed a typical “N” shape structure. The sum of the two included angles of the sinuses was ( 120.11 ± 30.32) °, and the failure rate was (86.37 ± 10.72) °. The difference between the two groups was statistically significant (t = 23.420, P = 0.001). The sinus diameter were (5.10 ± 1.12) and , The difference was not statistically significant (t = 7.210, P = 0.352). Conclusions The lateral cerebral venous angiography in the jugular foramen is “N” shaped. If the angle between the two sinuses is too small, stent implantation is difficult, but the diameter of the sinus does not affect the implantation of the stent.