致蛛网膜下腔出血的颅内破裂动脉瘤CT血管造影特点

目的探讨蛛网膜下腔出血的颅内破裂动脉瘤CT血管造影特点。方法选择自发性蛛网膜下腔出血行头颅CT血管造影(CTA)检查的患者115例。所有患者经外科手术或数字减影血管造影术(DSA)证实为颅内动脉瘤,并进行影像学特点分析。结果 115个破裂动脉瘤中,38个(33.0%)位于前交通动脉,16个(42.1%)伴有一侧大脑前动脉A1段发育不良或缺如;32个(27.8%)位于后交通动脉起始部。动脉瘤最大直径2～17.5(6.72±3.32)mm。37个(32.2%)动脉瘤最大直径<5 mm,72个(62.6%)动脉瘤最大直径<7 mm。颅内破裂动脉瘤体积13～2651(369.65±187.74)mm~3。63个(54.8%)动脉瘤体积<200 mm~3。24个(20.9%)动脉瘤长宽比≤1.8,91个(79.1%)动脉瘤长宽比>1.8。67个(58.3%)动脉瘤伴有子瘤。单发动脉瘤96例(83.5%);多发动脉瘤19例(16.5%),每例有1个责任动脉瘤即破裂动脉瘤,共19个,未破裂动脉瘤23个。破裂动脉瘤最大直径明显大于未破裂动脉瘤(P<0.05)。结论多层螺旋CT能为临床提供颅内破裂动脉瘤丰富的形态学信息。

CT angiography features of ruptured intracranial aneurysm resulting in subarachnoid hemorrhage

Objective To study the CT angiography(CTA) features of ruptured intracranial aneurysm. Methods One hundred and fifteen patients with spontaneous subarachnoid hemorrhage who underwent CTA were included in this study.Ruptured intracranial aneurysm was diagnosed in the patients during surgical operation or at DSA.Their CTA features were analyzed.Results Of the 115 ruptured aneurysms,38(33.0%) were located in the anterior communicating artery including 16(42.1%) with Al segment hypoplasia or absence of anterior cerebral artery,and 32 (27.8%) were located in the posterior communicating artery with a maximum diameter of 6.72±3.32 mm(2—17.5 mm).The maximum diameter of 37(32.2%) and 72(62.6%) ruptured aneurysms was <5 mm and <7 mm,respectively.The volume of ruptured aneurysm was 369.65±187.74 mm~3(13—2651 mm3).The volume of 63(54.8%) ruptured aneurysms was <200 mm3. The length and width ratio of 24(20.9%) and 91(79.1%) ruptured aneurysms was≤1.8 and > 1.8,respectively.Daughter aneurysm was found in 67(58.3%) ruptured aneurysms.Single aneurysm was detected in 96 patients(83.5%)and multiple aneurysms including 19 and 23 unruptured aneurysms were detected in 19 patients(16.5%).The maxmimum diameter of ruptured aneurysms was significantly larger than that of unruptured aneurysms(P<0.05).Conclusion Multislice spiral CT can provide rich morphological information for ruptured intracranial aneurysms.