摘要目的:探讨高分辨平板CT在颅内Willis覆膜支架置入术中的应用价值。方法:对郑州大学第一附属医院放射介入科自2017年6月至2019年8月收治的23例因颅内动脉瘤、椎动脉夹层或颈动脉海绵窦瘘而行颅内Willis覆膜支架置入术治疗的患者，使用DSA工作站对支架置入后普通平板CT和高分辨平板CT扫描结果分别进行后处理，比较不同方法显示的支架重建图像质量的差异；采用双容积重建融合技术将靶血管5 s-3D-DSA重建图像和高分辨平板CT扫描的支架重建图像进行融合，观察并评估支架完全打开及贴壁情况。结果:23例患者顺利置入25枚Willis覆膜支架，技术成功率达100%。与普通平板CT相比，高分辨平板CT能更清晰和直观地显示金属支架细节，图像质量评分有明显提高(0.56±0.71 vs. 1.56±0.65)，差异有统计学意义( P<0.05)。双容积重建融合技术观察到1枚支架头端金属丝U型连接处打折，但未见血管破裂及内漏等情况，余24枚支架完全打开并贴壁良好。 结论:高分辨平板CT能清晰展示支架打开程度及贴壁情况，进而指导术者采取相应的治疗策略，在颅内Willis覆膜支架置入术中具有较大的应用价值。

abstractsObjective:To evaluate the utility of high-resolution flat detector CT (HR-FDCT) in Willis covered stent implantation.Methods:The clinical and imaging data of 23 patients with intracranial aneurysms, intracranial artery dissection or carotid-cavernous fistula treated by Willis covered stents in our hospital from June 2017 to August 2019 were retrospectively analyzed. Images were acquired using conventional FDCT and HR-FDCT; the differences of image quality for stent visualization were compared. Immediately after stent deployment, dual volume 3D fusion images were obtained from 5 s-3D-digital subtraction angiography (DSA) and HR-FDCT, and the stent expansion status was also recorded.Results:A total of 25 Willis covered stents were implanted in 23 patients with a success rate of 100%. As compared with that by FDCT, visualization of fine structures of the stent by HR-FDCT was improved, and the image quality by HR-FDCT was significantly improved as compared with that by FDCT (mean scores: 0.56±0.71 vs. 1.56±0.65, P<0.05). According to the reconstruction of 3D fusion images obtained from 3D-DSA combined with HR-FDCT, one stent was found to have poor apposition (the distal of the stent with kinking) without vascular rupture and internal leakage, and the other 24 stents were found to have good apposition. Conclusions:HR-FDCT could better display Willis covered stent details and afford improved image quality, which instructs surgeons to adopt appropriate treatment strategy. This novel HR-FDCT has great application potential in Willis covered stent implantation.