Objective To explore the application value of CT fusion navigation technology in Stanford B-type aortic dissection endovas-cular isolation surgery.Methods Nineteen patients who underwent Stanford B-type aortic dissection endovascular isolation surgery were selected.Prior to surgery,all patients underwent chest and abdominal CT plain scan and enhanced scan,and three-dimensional vascular reconstruction was performed at the post-processing workstation;During the operation,a chest(region of interest)digital subtraction angiography(DS A)3D-CT scan was first performed as the intraoperative matching localization image.Then,a thin-layer(1.0 mm)CT enhanced tomographic image of the chest and abdomen was extracted from the picture archiving and communication system(PACS).At the same time,the DSA 3D-CT image and the thin-layer CT enhanced image were opened for overlapping regis-tration of bony landmarks.After registration,the three-dimensional vascular volume rendering(VR)image of the aorta from the thin-layer CT was fused with the DSA 3D-CT,and the positioning and release of the covered stent were guided by the newly fused multimodal real-time image.Results All 19 patients underwent guided surgery with precise positioning of the covered lesions and successful release of the covered stents,with a success rate of 100％ for the guided technique.The intraoperative placement time of the covered stent was(5.4±2.4)s,the exposure time was(12.8±3.2)min,the surgical duration was(53.9±25.3)min,the intraopera-tive contrast agent dosage was(125.8±25.3)mL,the X-ray fluoroscopy dose was(221.3±155.7)mGy,and the total X-ray exposure dose was(1 056.4±330.3)mGy.There were no serious complications during the operation,and all patients received 1-3 months of follow-up which found they all recovered well.Conclusion The use of CT and DSA fusion navigation technology in guiding the treat-ment of Stanford B-type aortic dissection with covered stents provides real-time three-dimensional fusion images for the operator,which can quickly and accurately locate and release the stent,and has certain clinical value.

Objective To explore the application value of CT fusion navigation technology in Stanford B-type aortic dissection endovas-cular isolation surgery.Methods Nineteen patients who underwent Stanford B-type aortic dissection endovascular isolation surgery were selected.Prior to surgery,all patients underwent chest and abdominal CT plain scan and enhanced scan,and three-dimensional vascular reconstruction was performed at the post-processing workstation;During the operation,a chest(region of interest)digital subtraction angiography(DS A)3D-CT scan was first performed as the intraoperative matching localization image.Then,a thin-layer(1.0 mm)CT enhanced tomographic image of the chest and abdomen was extracted from the picture archiving and communication system(PACS).At the same time,the DSA 3D-CT image and the thin-layer CT enhanced image were opened for overlapping regis-tration of bony landmarks.After registration,the three-dimensional vascular volume rendering(VR)image of the aorta from the thin-layer CT was fused with the DSA 3D-CT,and the positioning and release of the covered stent were guided by the newly fused multimodal real-time image.Results All 19 patients underwent guided surgery with precise positioning of the covered lesions and successful release of the covered stents,with a success rate of 100％ for the guided technique.The intraoperative placement time of the covered stent was(5.4±2.4)s,the exposure time was(12.8±3.2)min,the surgical duration was(53.9±25.3)min,the intraopera-tive contrast agent dosage was(125.8±25.3)mL,the X-ray fluoroscopy dose was(221.3±155.7)mGy,and the total X-ray exposure dose was(1 056.4±330.3)mGy.There were no serious complications during the operation,and all patients received 1-3 months of follow-up which found they all recovered well.Conclusion The use of CT and DSA fusion navigation technology in guiding the treat-ment of Stanford B-type aortic dissection with covered stents provides real-time three-dimensional fusion images for the operator,which can quickly and accurately locate and release the stent,and has certain clinical value.

Objective Toexplorethevalueofdualvolumereconstructionininterventionalembolizationofwideneckedintracranial aneurysms.Methods Theclinicalandimagingdataof30patientswithintracranialwideneckaneurysmrupturedwerecollectedfrom June2016toDecember2017intheMeizhouPeople’sHospital.Thetreatmentoftheintracranialwideneckedaneurysm,theposition andopeningofthestentreleasing,therelatedcomplications,andfollow-upreviewafter6monthswereretrospectivelyanalyzed.Results Ofthe30patients,therewere35aneurysms(4 multipleaneurysms),inwhich26caseswerestentsassisted,with26stentsimplanted, and4caseswereballoonassisted.3D-DSAwasperformedimmediatelyafteroperationandevaluatedbydualvolumereconstructionon AdvantageWorkstation (AW)postprocessing workstation.(1)26casesofdenseembolism ofaneurysmswithouttumorneckor tumorresidual(86.7%),3casesofaneurysmcervicalresidual(10%)and1casesoftumorresidual(0.33%);(2)26stentswithaccurate locationsandcompletereleases(100%).(3)2caseswithvasospasmandstentthrombosisduringoperation,and1casewithsecond aneurysmruptureduringoperation.(4)DSAreexaminationsinhalfayearafteroperations:3casesrecurred (11.5%)inthe26cases ofdenseembolism;theresidualin2casesincreasedin4ofaneurysmalneckresidualand2oftumorresidual,andtherestremained;26stentsstayedinthesamepositionandthestentsin3caseswerenarrowed.2D-DSA,3D-DSAanddualvolumereconstructioncould clearlyshowthedegreeofembolizationofaneurysmsin20cases(66.7%),25cases(83.3%)and30cases(100%),respectively.The degreeofembolizationofaneurysmswassignificantlydifferentinthreeimagingmethods(P＜0.05).Conclusion Intheprocessof interventionalembolizationforintracranialwideneckedaneurysm, doublevolumereconstructioncanbeusedtoshowtheeffectof embolization,thelocationofthestentandtherelationshipwith theneckoftheaneurysm,whichprovidesanassessmentofthe situationofaneurysmembolism,thedevelopmentoftheauxiliarystentandtheobjectivefortheselectionofthesurgicalstrategy.

Objective To explore the guiding role of double volume reconstruction (DVRT) in interventional embolization of intracranial aneurysms. Methods Ninety?six cases of subarachnoid hemorrhage with 115 aneurysms underwent total cerebrovascular angiography and interventional endovascular embolization of intracranial aneurysms in our hospital from January 2017 to December 2017 were retrospectively analyzed. They were randomly divided into observation group (n=48) and control group (n=48) according to random number method. In the control group, guided by the results of 2D?DSA and 3D?DSA 3D reconstruction, the aneurysm neck and tumor were fully exposed with the optimal position. the responsible aneurysms were performed with the interventional endovascular embolization. The operators finished the embolization According to the size and shape of aneurysms and the operative experience. In the observation group, the operators could speculate the embolization density of aneurysms by using the data of 3D reconstruction and digital subtraction reconstruction and adjusted the surgical plan to make the aneurysms had been completely embolized. The baseline data, treatment status, adverse cerebrovascular reaction and recurrence rate of aneurysms were compared between the two groups. All patients in the two groups were operated by Deputy chief surgeons or above of the neurosurgery department. The comparison of the counting data were tested by χ2. The measured data conformed to normal distribution were tested by independent sample t. Results Statistically, There was no significant differences in baseline data including sex, age, blood glucose, blood pressure and cerebral atherosclerosis between the two groups (P>0.05). Comparing the responsible aneurysms in different positions and sizes, the differences was not statistically significant (P>0.05).There was no statistically significant differences in the dosage of contrast media and the cost of operation between the two groups (P>0.05). The radiation dose and operation time in the observation group were smaller and shorter than those in the control group, but there was no statistical differences between the two groups (P<0.05). Statistically, The incidence of rerupture of aneurysm and thrombosis in the observation group was significantly lower than that in the control group (P<0.05). and The incidence of cerebral infarction and the recurrence rate of aneurysm in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in sex, age, blood glucose, blood pressure and cerebral atherosclerosis between the two groups (P>0.05).There was no significant difference in the location and size of responsible arterial tumors (χ2=0.148, P=0.929).There was no significant difference in the dosage of contrast agent and the cost of operation between the two groups (t=-0.769, 0.225; P>0.05). The radiation dose and operation time were (479.81 ± 51.21)mGy, (103.52 ± 10.18) minin the observation group and (511.95 ± 53.26)mGy, (114.60 ± 9.51)min in the control group. The difference was statistically significant (t=-1.376,-2.516; P<0.05).There were 1 case of rerupture of aneurysm in the observation group, 4 cases in the control group;There were 0 cases of thrombus, respectively, 3 cases in the control group. The difference was statistically significant (χ2=11.748, 4.256; P<0.05).There were 0 cases postoperative cerebral infarction occurred in the observation group, and aneurysm recurrence in 1 case. Four cases postoperative cerebral infarction occurred in the control group, and aneurysm recurrence in 3 cases, respectively. The difference was statistically significant (χ2=5.719, 10.811; P<0.05). Conclusions The clinical effect of interventional embolization of intracranial aneurysms under the guidance of double volume reconstruction is remarkable, and the effect of interventional embolization and the relationship with the peripheral vessels can be clearly demonstrated. It can reduce the incidence of adverse cerebral vascular reactions and the recurrence rate of aneurysms and reduce the intraoperative risk. It is worthy to be popularized in interventional embolization of intracranial aneurysms and follow?up after operation.