ABSTRACT
Objective To evaluate the application of rotational digital subtraction angiography(DSA) with three-dimensional(3D) reconstruction in the diagnosis and treatment of intracranial aneurysms.Methods Philips ALLUR12 system was employed to perform 2D and rotational DSA examination for 35 patients suspected of intracranial aneurysms with subarachnoid hemorrhage,and the 3D reconstruction of the arteries was then performed with computer to gain the stereopicture of localization and direction of the aneurysms,shape and size of aneurismal neck and vascular branch anatomy.The rotational DSA and 3D reconstructed images were compared with that of conventional 2D DSA.Results In the 35 patients,36 intracranial aneurysms out of 30 cases were found by conventional DSA,but there were 7 aneurysms with obscure direction and construction and 3 aneurysms with obscure aneurismal neck,and no sign of aneurysm was found in the other 5 patients by the conventional DSA.After rotational DSA and 3D reconstruction,additional 3 microaneurysms were found,with the result of final diagnosis of 39 aneurysms in total in 33 patients,though if still failed to find an aneurysm in two patients.The overall view of aneurysm,location and size of aneurysmal neck,anatomy of parent artery and vascular branches in the vicinity,and even the microaneurysms manifested themselves clearly by rotational DSA and 3D reconstruction examination,and the sheltering effects due to overlapping artery were avoided.Conclusion Rotational DSA can successfully display the aneurysm sac and anatomical structures of aneurysmal neck and surrounding vascular branches in a 270? rotational optic angle,and a stereopicture of aneurysmal size,direction,parent artery and surrounding vascular branches can be showed more clearly compared with conventional DSA.It can not only greatly improve the diagnostic sensitivity and reduce the rate of misdiagnosis,but also provides the doctors with overall and precise aneurysmal images for the operation and interventional treatment.
ABSTRACT
Objective To study the etiology, differential diagnosis and effective treatment of hyponatremia after the tumor resection in sellar area. Methods 25 patients with tumor in sellar area which have suffered hyponatremia after surgery were retrospectively analyzed. Among them 14 cases were underwent a whole resection, 6 cases great part resection, and 5 cases partial resection. Water and blood sodium and central vein pressure in these patients were daily examined after surgery. Methods of treatment were adopted according to the results of examination. Results All the patients have suffered hyponatremia after surgery, accounting for 21.4% of all patients with tumors in sellar area in the same period. There are 10 of syndrome of inappropriate antidiuretic hormone (SIADH) and 15 of cerebral salt wasting syndrome (CSWS). Twenty-four patients were cured, one died of pneumonia(ARDS). Conclusions After surgery, the hyponatremia is prone to emergence in the patients with tumors in sellar area and simultaneously invading the hypothalamus. SIADH and CSWS are easily confused in clinical diagnosis, so a careful differentiation should always be done and followed a right therapy.