目的 研究颅内动脉瘤在使用覆膜支架治疗后的形态学变化.方法 使用5只实验犬建立双侧颈动脉侧壁动脉瘤模型10枚,2周后使用覆膜支架对动脉瘤进行封堵治疗.分别于术前、术后即刻、术后2、4周行动脉瘤3.0 MR检查,观察动脉瘤形态学变化,术后4周将实验动物处死后行病理学研究.重点研究覆膜支架置入后不同时期动脉瘤体积的变化.统计软件使用SAS6.12.结果 3.0 MR能够在T2像清楚显示动脉瘤形态.术前、术后即刻、术后2、4周动脉瘤瘤体积分别为(100.17 ± 16.64)mm3,(97.25 ± 17.18)mm3,(44.11 ± 5.96)mm3和(33.75 ± 5.02)mm3,支架置入后不同时间动脉瘤体积比较差异有统计学意义(χ2 ＝ 22.254,P ＜ 0.01);术后2、4周动脉瘤体积较术前平均减小55.6%,66.2%;术后4周病理显示动脉瘤体完全纤维化.结论 动脉瘤在覆膜支架封堵治疗后体积能够明显缩小并最终完全纤维化,从而减轻其对周围结构的占位效应.%Objective To invastigate the morphologic changes of experimental aneurysms after isolated by covered stent implantation. Methods Ten experimental aneurysms were established in bilateral carotid arteries in five canines, which were isolated with covered stent two weeks later. MRI of the aneurysms with a 3-tesla unit was performed before, immediately after, 2 weeks and 4 weeks after the procedure, to observe their morphologic changes. Then the canines were sacrificed for pathologic study. The experiment was focused on the changes of aneurismal volume after cover stent implantation. Data thus obtained were analyzed by using SAS6.12 statistical software. Results The 3-tesla magnetic resonance unit could clearly display the aneurismal morphology on T2 imaging. The aneurismal volume were (100.17 ± 16.64)mm3. (97.25 ± 17.18)mm3, (44.11 ± 5.96)mm3 and (33.75 ± 5.02)mm3 at the time bef'ore, immediately after, 2 weeks and 4 weeks after the procedure respectively. Statistically significant difference in volume changes existed among groups (X2 = 22.254.P = 0.01). The average aneurismal volume decreased by 55.6％. 66.2％ at 2 weeks and 4 weeks after the procedure respectively when compared with that before procedure. Pathologically, the total aneurysms became fibrous degeneration 4 weeks after procedure. Conclusion The aneurysm can obviously decrease in volume and become totally fibrosed after isolated with covered stent, which can relieve the space-occupying effect of the aneurysm to the surrounding structures. (J Intervent Radiol, 2011, 20 : 131-134)
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