16层螺旋CT脑血管造影在脑动脉瘤诊断中的应用

目的 探讨16层螺旋CT脑血管造影对脑动脉瘤的诊断价值.方法 对74例怀疑颅内动脉瘤患者行头颅16层螺旋CT脑血管造影检查,应用多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)、容积显示(VR)及仿真内窥镜(VE)等后处理技术,并对照DSA及手术结果,评估诊断准确性.结果 16层螺旋CT脑血管造影发现动脉瘤65例共77个动脉瘤.其中单发动脉瘤55例,9例为2个动脉瘤,1例为4个动脉瘤:瘤体最小约2.0mm,最大约49mm;瘤颈最小约1.5 mm,最大约8.5 mm.与手术结果对比符合率为94.74%,同DSA对比灵敏度、诊断符合率差异均无统计学意义(P>0.05).结论 16层螺旋CT脑血管造影能清晰显示颅内动脉瘤瘤体的部位及走向.瘤颈、载瘤动脉以及动脉瘤与周围结构的空间关系,诊断脑动脉瘤有较高的准确性,可作为急诊颅内动脉瘤患者的首选检查方法.

Application of 16-slice spiral CT angiography in diagnosis of intracranial aneurysm

Objective To discuss the clinical diagnostic value of 16-slice spiral computed tomography angiography (CTA) for intracranial aneurysm. Methods Seventy-four patients with suspected intracranial aneurysm were examined with 16-slice spiral CTA. The post-processing techniques including multiplanar reconstruction (MPR), curved planar reformation (CPR), maximum intensity projection (MIP), volume rendering (VR) and virtual endoscopy (VE) were used, and their diagnostic accuracy was evaluated and compared with the results of digital subtraction angiography (DSA) and operation. Results A total of 77 aneurysms were detected by 16-slice spiral CTA in 65 patients. Among them, 55 patients had single aneurysm, 9 patients had double aneurysms, and only 1 patient had 4 aneurysms. The smallest diameters of aneurysm were 2.0 and 1.5 mm, and the largest were 49 and 8.5 mm at body and neck, respectively. The coincidence of aneurysms confirmed by operation and those detected by 16-slice spiral CTA was 94.74%. There were no significant difference in the sensitivity and the accordance rate of diagnosis between DSA and 16-slice spiral CTA (P>0.05). Conclusions 16-slice spiral CTA clearly showed the location, axis pointing, neck, parent artery ofa aneurysm, as well as the spatial relationship with the surrounding structures. The accuracy of 16-slice spiral CTA is higherin the diagnosis of intracranial aneurysm. It can be used as the first and effective choice for diagnosis of acute intracranial aneurysm.