64排螺旋CT造影诊断急性颅内动脉瘤破裂应用价值

目的探讨64层螺旋CT血管造影（CTA）在急性颅内动脉瘤破裂诊断中的作用。方法 20例经DSA或手术证实急性颅内动脉瘤破裂受检者,全部行CTA检查,对CTA诊断结果与手术结果及DSA进行对比,综合评价CTA的敏感性与特异性,优势和不足。使用CT机为Siemens SOMATOM Sensation Cardiac 64层,三维后处理为最大密度投影（MIP）、容积重建（VR）、Siemens Inspace及NeuroDSA软件,CTA的诊断结果由两名以上放射科医生和神经外科医生确定。结果 CTA发现阳性病例20例,共21个动脉瘤;其中前交通动脉瘤7个,大脑前动脉瘤4例,后交通动脉瘤5个,大脑中动脉瘤3个,颈内动脉瘤2例。结论 64层螺旋CTA诊断动脉瘤的敏感性、特异性及准确性高,CTA可作为蛛网膜下腔出血早期病因诊断学的首选方法。

Application Value of 64-Slice Spiral CT Angiography in Diagnosis of Acutely Ruptured Intracranial Aneurysms

Objective To evaluate the value of 64-slice Spiral CT angiography（CTA） in diagnosis of acutely ruptured intracranial aneurysms.Methods Totally 20cases of acutely ruptured intracranial aneurysms comfirmed by Digital Substraction Angiography（DSA） or operation were examined by CTA,and then compared between them.Source images were got by Siemens Sensation Cardiac 64 scanner,Maximum Intersity Project（MIP）,Volume Reconstruction（VR）,Siemens NeuroDSA and Inspace were adopted in all cases,Images of CTA were reviewed by 2 and more radiologists and neurosurgeons.Results Among 20 cases there were 21 intracranial aneurgsms,7 anterior communication aneurgsms,4 anterior cerebral artery aneurgsms,5 posterior communication aneurgsms,3 middle cerebral artery aneurgsms,2 internal cardotid artery aneurgsms.Conclusion 64-slice Spiral CT angiography has very high sensitivity,specificity and accuracy in the diagosis of intracranial aneurysms,CTA can be served as the first choice for subarachnoid hemorrhage to look for aneurysms.