256层螺旋CT血管成像诊断脑动脉瘤的价值并与DSA的比较

目的通过与数字减影血管造影(DSA)比较,探讨256层螺旋CT血管成像(CTA)诊断脑动脉瘤的价值。方法 190例脑动脉瘤患者行CTA检查,并均进行脑动脉DSA,对两种方法的表现进行回顾性分析,比较两者对脑动脉瘤的检出率,同时对CTA漏诊脑动脉瘤的原因进行分析。结果DSA诊断为脑动脉瘤190例,共228个病灶;行CTA检查,诊断脑动脉瘤172例,共210个病灶,CTA与DSA比较,检出率为92%;统计学检验结果提示两种方法无统计学意义(P0.05)。CTA漏诊动脉瘤的主要原因是去骨同时去掉近颅底的动脉瘤、主观上重建和观察欠缺、动脉瘤本身因素。结论 256层螺旋CT血管成像是诊断脑动脉瘤有价值的方法。了解CTA脑动脉漏诊原因,加以改进,能提高CTA对动脉瘤的检出率。

The Value of 256-Slice Spiral CT Angiography in the Diagnosis of Cerebral Aneurysm and Compared with DSA

Objective To evaluate the value of 256-slice spiral CT angiography in the diagnosis of cerebral aneurysm by compared with DSA. Methods 190 cases image data of CTA and DSA were retrospectively analyzed. Statistic test were done to compare the detecting rate of both ways in cerebral a aneurysm. And the reason of CTA leaking cerebral aneurysm would be analyzed. Results 190 cases and 228 lesions were diagnosed as cerebral aneurysm by DSA. 172 cases and 210 lesions were diagnosed as aneurysm by CTA. Compared with DSA, detecting rate of CTA was 92%. There was no statistical difference between CTA and DSA in detecting cerebral aneurysm（p〉0.05）. The reason of CTA leaking cerebral aneurysm were exclusing bone meanwhile removing aneurysm near bone, defects of subjective and reconstructing ways, self-causation of aneurysm. Conclusions CTA of 256-slice spiral CT was a value way in the diagnosis of cerebral aneurysm. Understanding causes of CTA leaking and improving could increase the detecting rate of cerebral aneurysm.