320排动态容积CT在颅内动脉瘤术后评价中的应用

目的:探讨320排动态容积CT在颅内动脉瘤术后评价中的价值.方法:2010年5月～2011年9月97例颅内动脉瘤术后患者行320排动态容积CT-DSA检查,其中行开颅夹闭术63例,血管介入栓塞术33例,栓塞并夹闭术1例.对未减影和减影图像采用容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)方法进行后处理.结果:本组97例患者图像优良率为96%,63例夹闭术及1例栓塞并夹闭术后患者共显示瘤夹65个,CTA均清晰显示动脉瘤夹位置、形态及与载瘤血管的关系;33例介入栓塞术后患者弹簧圈20例完全减掉,13例残留少许弹簧圈,但伪影较小.共发现动脉瘤残留3例,均为夹闭术后患者.此外,CTA显示2例载瘤动脉远端血管分支稀少,2例合并烟雾病,3例发现颅内其它部位动脉瘤,1例合并脑血管畸形.结论:320排动态容积CT可清晰显示动脉瘤术后有无瘤体残留、动脉瘤夹及栓塞材料与载瘤血管的关系,可以作为术后随访的首选检查方法.

Application of 320-detector row CT in postoperative evaluation of intracranial aneurysm

Objective：To investigate the value of 320-detector row CT in postoperative evaluation of intracranial aneu- rysm. Methods：Retrospective analysis was reviewed in 97 patients after intracranial aneurysm surgery from May 2010 to September 2011,of which 63 cases of craniotomy clipping surgery,vascular embolization in 33 cases,thrombosis and occlu- sion in 1 case. All patients underwent 320-detector row CT scan,the data were recontructed with subtraction technique and reformated with volume rendering （VR）,maximum intensity projection （MIP） and multi-planar reformation （MPR） tech- nique. Results：The imaging quality of 97 patients was good in 94% of patients,including 63 cases of clipping surgery and 1 case of aneurysm clipping and embolization treatment. The 65 clips were clearly showed for the location, shape and relation- ship with aneurysm parent vessel on CT reformation images. The artifacts of coil on CT images were totally eliminated in 20 of 33 cases after embolizatiomand partially elimited in 13 cases. For this clinical research,aneurysm remnants were found in 3 cases after clipping of aneurysm. In addition, CTA showed scarce distal branch of aneurysm in 2 cases and moyamoya disease in 2 cases,cerebral aneurysm in other location in three cases and vascular malformation in one case. Conclusion：The 320-detector row CT might help to clearly show aneurysm remnants after aneurysm surgery,and also display the relation- ship between the aneurysm clips or the embolization materials and the parent vessel. The 320-detector row dynamic volume CT could be used as method of choice for postoperative follow-up.