3D-CTA在颅内动脉瘤破裂开颅手术中的应用价值

目的探讨三维血管CT造影（3D-CTA）在颅内动脉瘤破裂开颅手术中的应用价值。方法经手术证实的颅内动脉瘤破裂导致蛛网膜下腔出血（SAH）或颅内血肿患者65例,术前均行3D-CTA检查并进行动脉瘤手术模拟,部分患者术前行DSA检查。将患者术前3D-CTA、术前DSA、术中所见进行比较,分析3D-CTA的临床应用价值。结果 65例患者共有动脉瘤68枚,3D-CTA发现65枚,诊断阳性率为95.59%,特异性为100%。3D-CTA可清晰显示动脉瘤位置、大小、形态、瘤顶指向、瘤颈宽窄、载瘤动脉、动脉瘤与周围血管及骨结构关系,且与术中所见基本一致。结论 3D-CTA是一种准确、快捷、微创的诊断颅内动脉瘤方法,能够提供足够信息指导动脉瘤的外科手术治疗。

Clinical value of three-dimensional computed tomography angiography in the operation of ruptured intracranial aneurysms

Objective To evaluate the clinical value of three-dimensional computed tomography angiography （3D-CTA） in the operation of ruptured intracranial aneurysms.Methods A total of 65 patients with subarachnoid hemorrhage （SAH） or intracerebral hematomas caused by ruptured intracranial aneurysms were confirmed by operation. All the patients were examined by 3D-CTA before operation and surgical simulation was conducted. Some patients were examined by the pre-operative digital subtract angiography （DSA）. Pre-operative 3D-CTA, DSA and intra-operative findings were compared to analyze the clinical value of 3D-CTA.Results In 65 patients, 68 aneurysms were detected, 65 of which were detected by 3D-CTA, with a sensitivity of 95.59% and a specificity of 100%. 3D-CTA clearly displayed the location, size, and shape of aneurysms, the direction of its growth, the width of aneurysms neck and the relationship between the parent artery, aneurysms and the surrounding structures, which were in accordance with the intra-operative findings. Conclusion 3D-CTA is an accurate, fast and minimally invasive method for the diagnosis of intracranial aneurysms and may be helpful for its surgical intervention.