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数字减影血管造影联合CT血管成像对颅内动脉瘤的诊治探讨
引用本文:闵晓黎,曹毅,何敬,杨燕,万启南,万春平,何国祥.数字减影血管造影联合CT血管成像对颅内动脉瘤的诊治探讨[J].中国CT和MRI杂志,2017(2).
作者姓名:闵晓黎  曹毅  何敬  杨燕  万启南  万春平  何国祥
作者单位:1. 云南中医学院临床学院西医内科教研室 云南 昆明 650500; 云南中医学院第一附属医院放射科 云南 昆明 650021;2. 昆明医科大学第二附属医院神经外科 云南 昆明 650101;3. 云南中医学院第一附属医院放射科 云南 昆明 650021;4. 丽江市医院神经内科 云南 丽江 674100
摘    要:目的探讨数字减影血管造影联合CT血管成像对颅内动脉瘤的诊治价值。方法回顾性分析经数字减影血管造影确诊为颅内动脉瘤的62例患者的颅脑3D-DSA及CTA检查资料,观察动脉瘤部位、形态、大小、瘤体颈比、与载瘤动脉的关系以及动脉瘤与邻近神经、颅骨等其他组织结构的关系等。结果经3DDSA检出动脉瘤54例(60个),检出率约87.1%(54/62);经CTA检出动脉瘤50例(50个),检出率约80.7%(50/62),两者比较无统计学差异。3D-DSA能较清晰显示动脉瘤瘤颈的大小及瘤体与载瘤动脉的关系,显示率达100%(60/60),并能较好显示动脉瘤穿支血管。而CTA对动脉瘤的显示除颈内动脉有统计学差异外,颅内其余部位血管显示率无统计学差异,而对动脉瘤穿支血管显示能力较差。结论个性化检查和两者的综合运用能充分发挥优势,对于提高动脉瘤的诊治水平具有重要的价值。

关 键 词:颅内动脉瘤  数字减影血管造影  CT血管成像

Digital Subtraction Angiography Combined CT Angiography for the Diagnosis and Treatment of Intracranial Aneurysms
Abstract:Objective To investigate the value of digital subtraction angiography and CT angiography in the diagnosis and treatment of intracranial aneurysms. Methods The3D-DSA and CTA data of 62 patients with intracranial aneurysm diagnosed by DSA were retrospectively analyzed, the aneurysm location, shape, size and neck/body ratio were measured, as well the relationship between the aneurysm and the aneurysm bearing artery, the aneurysm and the adjacent structures such as nerve and the skull were evaluated. Results The totalof 54 cases (60 aneurysms) were detected by 3D-DSA and the relevance rate was about 87.1%(54/62), while for CTA there were 50 cases (50 aneurysms) detected and the relevance rate was about 80.7%(50/62). There is no statistical difference between the relevance rate detected by the two methods. On the other side, 3D-DSA can clearly show the size of aneurysm neck and the relationship between the aneurysm and the aneurysm bearing artery, the display rate was reached to 100%(60/60), and also can better display the perforator vessels of aneurysm. While for CTA, the display rate of aneurysm located in the internal carotid artery showed a significant difference but not for that located in the intracranial vascular, and has a poorer ability to display the perforator vessels of aneurysm. Conclusion Personalized alternation and the comprehensive application of the both methods can give full play to their respective advantages, which will be important for improving the level of diagnosis and treatment of aneurysm.
Keywords:Intracranial Aneurysm  Digital Subtraction Angiography  Computed Tomography Angiography
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