64层螺旋CT减影与未减影技术对颅内动脉瘤术后评价

目的探讨64层螺旋CT减影与未减影技术脑血管成像方法及其在颅内动脉瘤术后评价中的价值。方法颅内动脉瘤夹闭术16例、栓塞术12例患者术后复查,全部行64层螺旋CT平扫、增强动脉期从颅顶向颅底扫描获得未减影数据。将动脉期数据减去平扫数据获得动脉的减影数据。对未减影和减影图像采用容积再现（VR）、薄层最大密度投影（TSMIP）、多平面成像（MPR）重建。结果颅内动脉密度较静脉密度明显高,血管减影图像与未减影图像相比,二者图像质量相似（P〉0.05）。减影图像去除了颅骨和瘤夹、弹簧圈的干扰;未减影图像则同时显示血管和颅骨、瘤夹、弹簧圈,对颅内血管与瘤夹关系显示直观,但弹簧圈伪影干扰大。1例左侧大脑中动脉夹闭术后载瘤动脉中断,1例右侧颈内动脉动脉瘤栓塞术后中断,所有患者全部动脉瘤夹无脱移,未见残动脉瘤残留。结论 64层螺旋CT同步扫描是一种安全、可靠的技术,减影与未减影结合运用可准确评价颅内动脉瘤术后改变。

Application of 64-shoe spiral CT scan synchronous in the postoperative evaluation of intracranial aneurysms

Objective To investigate the value of 64-slice spiral CT scan synchronous in the postoperative of intracranial aneurysms.Methods 16 cases with the intracranial aneurysms were clipped and 12 cases were embolized.64-slice spiral CT scan was employed to check them after operation.Plain and enhanced arterial phase were performed from the parietal to the bases of skull.Non subtraction data of enhanced arterial phase subtracted plain data to obtain data subtraction artery.Non subtraction and subtraction images using volume rendering（VR）,thin-slab maximum intensity projection（TSMIP）,multi-plane reconstruction（MPR）.Results The artery density of intracranial aneurysms was significantly higher than that of the vein,and blood vessels image quality subtraction and non subtraction images compared similarly.Subtraction images removed interfere of the skull and the clip,circlip ring;non subtraction images showed that blood vessels and the skull,aneurysm clip,circlip ring,but the circlip ring artifact interference.1 case of the left middle cerebral artery interrupted by clip,1 cases of the right internal carotid artery aneurysm after embolization interruption,all clips were not shifted,had no residual aneurysm remnant.Conclusion The 64-slice spiral CT scan synchronous is a safe,reliable technology;subtraction and non subtraction combined can accurately evaluated the postoperative information of intracranial aneurysms.