16层CTA在脑血管疾病中的临床应用研究

目的通过与DSA和手术对照,评价16层螺旋CT血管造影(CTA)在脑血管病诊断中的价值。方法应用16层螺旋CT增强扫描获得原始横断面图像,采用容积显示(volume rendering VR)及最大密度投影(maximum intensity projection MIP)技术进行扫描范围内脑血管三维成像,回顾性分析31例脑血管病患者CTA检查。结果CTA检出脑血管异常30例,CTA检出颅内动脉瘤22例(共25个),动静脉畸形6例,硬脑膜动脉静脉瘘1例,静脉血管畸形1例。对动脉瘤检出的敏感性为92.3%,对脑血管病总符合率96.8%。CTA能够清晰显示动脉瘤瘤体(形态、指向、轮廓)、瘤颈的宽度、载瘤动脉及与颅骨之间的关系,显示脑血管畸形的部位、范围、供血动脉及引流静脉的情况。结论16层螺旋CT血管成像图像质量高,能快速、安全、无创有效地诊断脑血管疾病,尤其适用于颅内动脉瘤破裂及脑血管畸形出血等急症病人的筛选。

Clinical application study on 16-slice CT Angiography in diagnosis of cerebral vascular diseases

Objective To evaluate the value of 16-slice CT angiography (CTA) in diagnosis of cerebral vascular diseases by the comparison with digital subtraction angiography (DSA) and operation. Methods The original enhanced axial CT images were performed by 16-slice helical CT. 3-dimensional intracranial vessel images were obtained by using volume rendering (VR) and maximum intensity projection (MIP) reconstruction technique. CTA of 31 cases of cerebral vascular diseases was retrospectively analyzed. Results There are 30 cases cerebral vascular abnormal were detected in 30 cases by CTA method , including 22 cases of aneurysms and 6 cases of arteriovenous malformation(AVM) and 1 case of dural arteriovenous fistula and 1 case of venous malformation. The sensitivity that detected the aneurysm cases was 92.3% and the total diagnosis accordance rate of cerebral vascular disease was 96.8%. The body of aneurysms (including morphology, outline and the develop orientation), neck, the relationship to surrounding vessels and its space relations with the skull were demonstrated on CTA. Site, extension, their supply arteries and drainage veins of cerebral vascular malformation were also well displayed. Conclusion 16-slice CTA is a fast, safe, noninvasive and efficient technique in diagnosing of cerebral vascular diseases. CTA can be specially used to screen in rupture of aneurysms and acute hemorrhage of cerebral vascular malformation.