探讨DSA、Dyna-CT及MRI影像融合技术的开发与在脑脊髓血管病中的应用价值。

应用我院2011年引进的Siemens Artis Zee所带Dyna-CT与2006年引进的GE-3100所带的Innova-CT及其后处理软件：双容积（dural volume)、静脉CTA、三维融合（three dimensimal fusion)、计算脑灌注血容量（parenchyma blood volume PBV)、Siemens iFlow、GE-Agioviz等后处理技术，在临床进行脑脊髓血管病血管内介入诊断治疗时，在DSA造影后进行三维重建、三维融合等后处理，获得三维融合图像、脑血容量图像、脑血流全循环图像。

利用两台DSA机器，进行了双容积重建，可以评价颅内、颈部植入支架后观察支架展开情况，可以评价颅内动脉瘤的栓塞效果，可以看清颅内动脉及动脉瘤有无钙化，颅内及脊髓血管病变在正位、侧位与轴位上与颅骨、颅底及脊椎骨质结构的关系；可以从静脉CTA评价颅内血管病变，如动脉瘤、AVM等，进行DSA双侧颈内动脉系统、一侧颈内动脉系统与一侧椎基动脉系统三维血管重建后评价脑血管病，尤其是AVM的供血全貌；通过降血压BOT(balloon occlusion test，球囊闭塞试验）前后脑血容量变化找出了作为评估颈内动脉能否闭塞的金标准新的参考指标；建成了脑动静脉、静脉窦全循环像以及利用DSA与MRI影像融合后数据输入Mecromic神经导航行颅内深部动脉瘤与动静脉畸形的直视手术获得成功。

DSA与CT、MRI影像融合后的三维影像对脑脊髓血管病的诊断、治疗有较大指导参考价值，甚至对科学研究及教学也有更直观、更有价值的帮助，多种影像融合是未来医学影像的发展方向。

In this study, we discuss the development of DSA and MRI image fusion technology and its application value in cerebral spinal vascular disease.

Application of our hospital Siemens Artis Zee with Dyna-CT introduced in 2011 and GE-3100 with Innova-CT introduced in 2006 and them post-processing software: such as Dural Volume, Intravenous CTA, Three dimensional Fusions, Parenchyma blood Volume (PBV), Siemens iFlow and GE-Agioviz, etc. When in the clinical interventional diagnosis and treatment of cerebrospinal vascular disease, three dimensional fusion image, cerebral blood volume and full cycle of the cerebral blood flow images were obtained by 3D reconstruction, 3D fusion and so on post-processing technology after DSA angiography.

Using two DSA machine to reconstruct dural volume, we can evaluate intracranial and neck stent expanded after placement and the effect of embolization of intracranial aneurysms, and determine whether intracranial artery and aneurysm presence of calcification, as well as identify intracranial and spinal vascular lesions relationship with the skull, skull base and spine bone structure in orthotopic, lateral and axial. We can apply the CTA evaluation of intracranial vascular lesions, such as aneurysm, AVM and so on. We can evaluate cerebrovascular diseases, especially the AVM blood supply, through the bilateral internal carotid artery system, unilateral internal carotid artery system and unilateral vertebral artery DSA three-dimensional vascular remodeling. We find out the new reference index of the gold standard of internal carotid artery occlusion by observing cerebral blood volume changes before and after the fall blood pressure BOT(balloon occlusion test). We built the full cycle image of brain arteries, veins and venous sinus and have successfully completed the fistula operation of deep intracranial aneurysm and arteriovenous via input the DSA and MRI images fusion data to Mecromic neural navigation.

Three-dimensional imaging fusion of DSA, CT and MRI images have great reference value in the diagnosis and treatment of cerebral spinal vascular disease, even have more intuitive and valuable help to the scientific research and teaching. A variety of image fusion is the future development direction of medical image.