64层螺旋CT同步减影技术在颅内动脉瘤中的应用价值

目的:探讨64层螺旋CT同步减影技术(SSCTA)在颅内动脉瘤诊断中的应用价值.方法:回顾性分析31例经手术和(或)DSA确诊为动脉瘤患者CTA资料.所有患者均行同步减影CTA检查.用容积再现(VR)和最大密度投影(MIP)重组方式显示;以手术和(或)DSA为标准对图像进行分析.结果:SSCTA可以完全去除颅底复杂的骨结构干扰,得到较高质量的CTA图像;可以大幅度降低CTA的三维重组时间;可以充分显示颅内动脉瘤部位、大小、形态,局部特写有利于显示动脉瘤体,瘤颈与载瘤动脉的关系.SSCTA共检出动脉瘤34个,3例多发;其中颈内动脉颅底段21个,大脑中动脉3个,前交通动脉瘤7个,椎动脉瘤3个;最大者15.7mm×15.3mm,最小2.3mm×2.2mm;经与手术及DSA结果比较,SSCTA检出动脉瘤的敏感性100%,特异性100%.结论:SSCTA对颅内动脉瘤的诊断具备安全、无创、快捷,且血管图像分辨率高,对靠近颈内动脉颅底部的动脉瘤显示具有较高的特异性及敏感性,可作为临床首选的颅内动脉瘤筛选方法.     

颅内动脉瘤的CTA术前诊断

评价CT血管造影(CTA)在颅内动脉瘤的术前诊断价值及对最大密度投影(MIP)、表面遮盖显示(SSD)和容积显示技术(VRT)作用的比较.材料和方法:对36例CT平扫怀疑患有颅内动脉瘤的患者进行CTA检查,初选27例动脉瘤患者分别进行MIP、SSD及VRT成像,观察动脉瘤的部位、形态、生长方向及载瘤动脉;进行瘤体大小及瘤颈宽度的测量,部分病例与术中结果比较.结果:27例动脉瘤患者中,动脉瘤大小:5～60mm.瘤颈呈蒂状(颈宽＜10mm)18例、宽颈(颈宽≥10mm)9例.载瘤动脉分别为:大脑中动脉(12例)、大脑前交通动脉(7例)、颈内动脉虹吸部(6例)、基底动脉(2例).蒂状窄颈动脉瘤均行手术治疗,术后恢复良好;1例瘤颈宽为10mm手术后患者所在中动脉闭塞,脑组织缺血性梗死,9例均放弃手术.结论:CTA可作为动脉瘤的有效术前筛选诊断,可作为神经外科医师手术前的重要指导方法之一.     

64层螺旋CT脑血管造影在颅内动脉瘤诊断中的应用

目的:与DSA相对照,探讨64层螺旋CT脑血管造影在颅内动脉瘤中的诊断价值。方法:对29例临床怀疑颅内动脉瘤的患者行64层螺旋CT脑血管造影(CTA)和DSA检查,使用GE64层Lightspeed VCT获得原始图像,所有病例均采用多层面重建(multiplanar reconstruction,MPR)、容积再现(volume rendering,VR)、薄层块最大密度投影(thin-slab maximumintensity projectjon,TS MIP)。后处理图像及DSA图像由2位放射科医生共同评估。结果:29例患者中,DSA证实25例共27个动脉瘤,其中2例为2个动脉瘤。与DSA结果相对照,CTA共检出25例26个动脉瘤,漏诊了1个颈出动脉瘤。CTA清晰显示了动脉瘤的形态、大小及载瘤动脉,3例动脉瘤瘤颈DSA未显示,CTA显示了全部动脉瘤的瘤颈。结论:64层CTA在颅内动脉瘤的诊断中具有极高价值,特别在显示动脉瘤瘤颈方面具有独特的优势,对临床治疗具有指导意义。     

颅内动脉瘤的MSCTA诊断

目的:探讨64层螺旋CT血管成像(64-MSCTA)对颅内动脉瘤的诊断价值。方法:搜集经DSA和手术证实的颅内动脉瘤18例,所有的病例均行64层螺旋CT血管成像。分别用最大密度投影(MIP)、容积再现(VR)、多平面重组(MPR)法进行图像重组。13例行手术治疗,5例行DSA检查。结果:18例患者中MSCTA发现动脉瘤17个,其中大脑中动脉7个,大脑前动脉6个,大脑后动脉2个,颈内动脉2个。1例左侧颈内动脉瘤MSCTA漏诊,经DSA检查发现。MSCTA上动脉瘤显示直径3～20mm。MSCTA所发现的17个动脉瘤与手术及DSA所见的动脉瘤位置、大小、形态基本一致。结论:MSCTA能清楚显示颅内动脉瘤的形态、位置及其与周围的解剖关系,为手术或介入治疗动脉瘤提供有价值的信息。     

16层螺旋CT三维重组技术在评价颅内小动脉瘤中的价值

目的 探讨16层螺旋CT三维重组技术评价颅内小动脉瘤(直径≤5mm)的准确性和临床应用价值.资料与方法 337例临床怀疑颅内动脉瘤的患者均行16层螺旋CT血管成像(CTA),其三维CT图像与常规DSA和外科手术结果 进行回顾性对比研究.三维重组方法 为最大密度投影和容积再现技术.结果 结合CTA、DSA和术中所见,337例中的84例患者发现95个小动脉瘤.CTA漏诊4个小动脉瘤,DSA漏诊6个小动脉瘤.16层螺旋CTA对于小动脉瘤诊断的准确性与DSA的结果 差异无统计学意义.16层螺旋CT三维重组图像可以更准确地显示小动脉瘤的瘤体和瘤颈与周围血管的系,为小动脉瘤的治疗提供有价值的信息.结论 16层螺旋CTA在小动脉瘤诊断方面有很高的准确性,可以作为颅内小动脉瘤筛查的首选影像方法 ,能够在小动脉瘤的治疗方面提供足够的诊断信息.     

旋转DSA及三维重建技术在颅内动脉瘤诊断中的应用价值

目的 评价旋转DSA及血管三维重建技术在颅内动脉瘤诊断中的价值.方法 40例蛛网膜下腔出血患者应用传统DSA,旋转DSA 及血管三维重建进行检查,对比不同方法对动脉瘤病变的显示情况.结果 40例患者均确诊为颅内动脉瘤,共45个动脉瘤.常规正侧位DSA能显示存在动脉瘤病变,但仅极少数病例能明确显示瘤颈和载瘤动脉的关系.旋转DSA显示动脉瘤结构的能力较常规DSA明显提高.所有血管三维重建的图像都清晰显示了颅内动脉瘤瘤体、瘤颈形态及载瘤动脉关系.结论 旋转DSA及血管三维重建技术对颅内动脉瘤病变结构显示极佳,尤其是三维重建技术,明显有助于提高对颅内动脉瘤的诊断和介入治疗.     

双源CT血管成像诊断颅内动脉瘤的价值并与DSA比较

目的探讨双源CT血管成像(DSCTA)多种后处理技术对颅内动脉瘤的诊断价值。方法回顾性分析经手术或数字减影血管造影术(DSA)证实的颅内动脉瘤38例。采用西门子双源CT机(Somatom Definition),所得原始数据在工作站采用容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)、曲面重组(CPR)、去骨减影及双能去骨减影技术对动脉瘤的大小、瘤颈、瘤内血栓、瘤壁钙化及载瘤动脉等方面进行显示。结果 DSCTA显示颅内动脉瘤38例,单发33例,4例为2个动脉瘤,1例为3个动脉瘤,共44个动脉瘤。颈内动脉17个,前交通动脉8个,基底动脉6个,后交通动脉5个,大脑中动脉4个,大脑前动脉4个。动脉瘤平均直径(7.2±1.7)mm,最小动脉瘤直径2.1 mm。清晰显示瘤颈38例,44个动脉瘤瘤壁钙化4例,瘤内血栓3例。结论 DSCTA多模式重建技术可清楚显示颅内动脉瘤的大小、形态、位置、多少及其与周围结构的关系,是颅内动脉瘤的检出及制定治疗计划的非常有用的方法。     

颅内动脉瘤术后夹闭不全和载瘤动脉闭塞的64层CTA评价

目的 评价颅内动脉瘤术后夹闭不全和载瘤动脉闭塞的CT血管造影(CTA)表现,分析导致夹闭不全和载瘤动脉闭塞的可能原因.方法 回顾性分析118例颅内动脉瘤夹闭术后患者的CTA资料,使用64层螺旋CT扫描和多平面重组(MPR)、最大密度投影(MIP)、容积再现(VR)图像后处理技术,并与数字造影血管造影(DSA)对照,评价术后载瘤动脉的CTA表现,尤其是瘤夹的位置、夹闭不成功时残存瘤体的形态.结果 112例载瘤动脉通畅,6例经DSA证实有动脉瘤夹闭不全(5例)和载瘤动脉闭塞(1例).所有钛夹显示清楚,无伪影.动脉瘤夹闭不全在CTA上表现为瘤夹周围残存小结节状、锥状、泡状或囊袋状动脉瘤影,分别位于前交通动脉处(2例)、右侧大脑中动脉水平段远端分叉处(2例)、左侧大脑中动脉水平段远端分叉处(1例).1例左侧颈内-后交通动脉瘤夹闭术后载瘤动脉闭塞,CTA表现为相应节段的动脉未见显影.结论 64层MSCTA能清晰显示颅内动脉瘤术后钛合金瘤夹的位置与形态、载瘤动脉的通畅情况以及夹闭不全时残存的动脉瘤.     

多层螺旋CT血管造影对颅内动脉瘤的诊断价值

目的:探讨多层螺旋CT血管造影(CTA)对颅内动脉瘤的诊断价值。方法:对36例蛛网膜下腔出血(SAH)的动脉瘤疑似患者均行多层螺旋CT血管造影检查和数字减影血管造影(DSA)检查,将两种检查结果进行对照分析、比较优缺点,CTA后处理采用容积再现(VRT)、最大密度投影(MIP)和表面覆盖法(SSD)。CTA重建采用0.75mm层厚、0.7mm层间隔,延迟扫描时间采用提前监控、静脉团注法。两位放射专家用盲法分析CTA、DSA资料,对颅内动脉瘤作出诊断。结果:36例SAH病例中,CTA发现32例37个动脉瘤,包括前交通动脉瘤15个、大脑前动脉瘤2个、后交通支9个、颈内动脉4个、大脑中动脉主干5个、基底动脉2个,其中1例CTA检查为颈内动脉海绵窦段动脉瘤,直径<3mm,DSA检查为阴性,其余均经DSA证实。4例SAH病例CTA、DSA检查均为阴性。CTA能够清晰显示瘤体、瘤颈、载瘤动脉及毗邻关系,其敏感性为94.5%。动脉瘤直径大于3.0mm者,CTA、DSA检查结果基本一致。CTA以VRT重建效果最佳。结论:CTA对于动脉瘤疑似患者是一种安全、无创伤的检查技术,能够精确显示动脉瘤的空间关系,可作为颅内动脉瘤首选的诊断方法。     

16层螺旋CT血管造影在颅内动脉瘤诊断中的应用

目的：研究多层螺旋CT血管造影诊断颅内动脉瘤的应用价值。方法：16层螺旋CT机对怀疑有顷内动脉瘤的28例患者行CTA裣查，将啄始数据输入Vitrca2工作站，重建颅内血管三维图像，进行多平面重建（MPR）、容积重建（VR）、最大密度投影法（MIP）等后处理，并对照手术或介入栓塞结果评估其诊断价值。结果：MSCTA共发现28例33个动脉瘤，动脉瘤直径最小3mm，最大25mm。MSCTA能清晰显示动脉瘤的瘤体大小、瘤颈、载瘤动脉及其动脉瘤与临近血管分支和骨性组织间的空间关系。27例与手术／DSA结果一致。结论：MSCTA诊断颅内动脉瘤有较高准确性，可部分取代DSA造影检查。     

多层螺旋CT血管成像诊断颅内动脉瘤的价值

目的:探讨多层螺旋CT血管成像诊断颅内动脉瘤的价值。材料和方法:对比分析21例颅内动脉瘤的多层螺旋CT血管成像(MSCTA)和数字减影血管成像(DSA)的表现。结果:21例中,MSCTA发现21个动脉瘤,DSA发现20个动脉瘤,其中1例双侧动脉瘤,DSA只发现1侧,另1例MSCTA及DSA均未发现病变;21个动脉瘤中18个为圆形或类圆形,3个为不规则形,平均最长径为6.9mm(2.2~15mm);21个动脉瘤1个位于后交通动脉,2个位于基底动脉,5个位于大脑前动脉,5个位于大脑中动脉,8个位于前交通动脉。结论:MSCTA对颅内动脉瘤的诊断具有较高价值,可以作为外科治疗或介入治疗颅内动脉瘤的筛选方法。     

多层CT血管成像与数字减影血管造影诊断颅内微小动脉瘤的比较

目的 探讨MSCTA对最大径≤3 mm颅内微小动脉瘤(IMA)的诊断价值.方法 回顾性分析连续826例可疑颅内动脉瘤患者的临床和影像资料.全部患者住院前(发病后2 h～4 d)均采用16层螺旋CT行MSCTA,全部颅内动脉瘤均经DSA、三维旋转数字减影血管造影(3DRA)或手术证实.MSCTA、DSA及3DRA等影像资料由2名放射科医师独立进行分析.以DSA或3DRA为标准,计算MSCTA诊断IMA的敏感性、特异性及准确度,采用Kappa分析,评价DSA或3DRA与MSCTA两种检查方法诊断颅内IMA的一致性.采用X~2检验分析IMA与非IMA患者多发动脉瘤的患病率.结果 826例可疑颅内动脉瘤患者中,788例为颅内动脉瘤患者,单发706例,多发82例,共发现889个动脉瘤,38例MSCTA、DSA或3DRA检查结果均为阴性.经DSA或3DRA检查证实,212例患者(271个动脉瘤)共有232个IMA.MSCTA检出229个IMA,假阳性1例,漏诊4个.以DSA或3DRA为标准,MSCTA诊断IMA的敏感性、特异性、准确度分别为98.3%(228/232)、97.4%(38/39)、98.2%(266/271).两种检查方法有较强的一致性(Kappa值为0.927,P<0.05).IMA与非IMA患者多发动脉瘤患病率分别为21.2%(45/212)、6.4%(37/576),差异有统计学意义(X~2=36.421,P<0.01).结论 MSCTA诊断IMA具有较高价值,鉴于MSCTA对IMA的检出达到≤3 mm水准,提出将颅内IMA影像大小界定从4～5 mm调整为≤3 mm.     

16层螺旋CT血管造影诊断颅内动脉瘤

目的:探讨16层螺旋CT血管造影(MSCTA)诊断颅内动脉瘤的准确性。材料和方法:30例临床怀疑颅内动脉瘤的患者分别进行16层螺旋CT脑血管三维成像(3D-MSCTA)和数字减影血管造影(DSA),所有病例均完成多层面重建(MPR)、三维表面遮盖显示(SSD)、容积显示(VR)和薄层块最大密度投影(MIP),并对照手术或介入栓塞结果评估其诊断价值。结果:MSCTA共发现24例28个动脉瘤,其中22例为单个动脉瘤,2例为两个动脉瘤。动脉瘤直径最小2.7mm,最大35mm。MSCTA能清晰显示动脉瘤的瘤体大小、瘤颈、瘤轴指向、载瘤动脉及其动脉瘤与临近血管分支和骨性组织间的空间关系。23例与手术/DSA结果一致。结论:MSCTA诊断颅内动脉瘤有较高准确性,可部分取代DSA造影检查。     

64层3D-CTA与3D-DSA对颅内动脉瘤评价的对比研究

目的 对比评价64层螺旋CT三维血管造影(3D-CTA)与三维数字减影血管造影(3D-DSA)对颅内动脉瘤的诊断价值.方法 28例临床怀疑颅内动脉瘤的患者均行64层螺旋CT血管造影和DSA,CT三维后处理主要包括容积重建(VR)及最大密度投影(MIP).常规二维DSA检查后,对可疑病变血管行旋转DSA检查,应用三维工作软件行3D后处理,比较3D-CTA与3D-DSA对动脉瘤显示的价值.结果 28例病例中22例CTA和DSA均显示动脉瘤并经手术或栓塞证实,其中1例CTA和DSA显示单个动脉瘤,手术证实为2个动脉瘤,1例CTA显示假阳性.3D-CTA与3D-DSA均能清楚显示动脉瘤形状、瘤径指向、瘤体直径、瘤颈、载瘤动脉、瘤体穿动脉情况,两者无明显差异.结论 64层3D-CTA在颅内动脉瘤诊断及细节显示上与3D-DSA无明显差异,一定程度上应能替代血管造影,指导临床治疗.     

Detection of aneurysms by 64-section multidetector CT angiography in patients acutely suspected of having an intracranial aneurysm and comparison with digital subtraction and 3D rotational angiography

BACKGROUND AND PURPOSE: Four-section multisection CT angiography (MSCTA) accurately detects aneurysms at or more than 4 mm but is less accurate for those less than 4 mm. Our purpose was to determine the accuracy of 64-section MSCTA (64MSCTA) in aneurysm detection versus combined digital subtraction angiography (DSA) and 3D rotational angiography (3DRA).MATERIALS AND METHODS: In a retrospective review of patients studied because of acute symptoms suspicious for arising from an intracranial aneurysm, 63 subjects were included who had undergone CT angiography (CTA). Of these, 36 underwent catheter DSA; all but 4 were also studied with 3DRA. The most common indication was subarachnoid hemorrhage (SAH; n = 43). Two neuroradiologists independently reviewed each CTA, DSA, and 3DRA.RESULTS: A total of 41 aneurysms were found in 28 patients. The mean size was 6.09 mm on DSA/3DRA and 5.98 mm on 64MSCTA. κ was excellent (0.97) between the aneurysm size on 64MSCTA and DSA/3DRA. Ultimately, 37 aneurysms were detected by DSA/3DRA in 25 of the 36 patients who underwent conventional angiography. The reviewers noted four 1- to 1.5-mm sessile outpouchings only on 3DRA; none were considered a source of SAH. One 64MSCTA was false positive, whereas one 2-mm aneurysm was missed by CTA. The sensitivity of CTA for aneurysms less than 4 mm was 92.3%, whereas it was 100% for those 4–10 mm and more than 10 mm, excluding the indeterminate, sessile lesions.CONCLUSIONS: In comparison with the available literature, 64MSCTA may have improved the detection of less than 4-mm aneurysms compared with 4- or 16-section CTA. However, the combination of DSA with 3DRA is currently the most sensitive technique to detect untreated aneurysms and should be considered in suspicious cases of SAH where the aneurysm is not depicted by 64MSCTA, because 64MSCTA may occasionally miss aneurysms less than 3–4 mm size.

Aneurysms are one of the most important causes of subarachnoid hemorrhage (SAH), with a fatality rate between 40% and 60%, whereas misdiagnosis is associated with further increased morbidity and mortality.^1,2 Traditionally, catheter digital subtraction angiography (DSA) has been considered the “gold standard” for aneurysm detection; currently, 3D rotational DSA (3DRA; obtained via the catheter angiogram) may offer increased aneurysm detection, with improved visualization of an aneurysm''s configuration and contour compared with DSA alone.^3–6 However, the combination of DSA/3DRA is invasive, time consuming, and may involve neurologic complications in 1%–2%.^7,8 Hence, an accurate, noninvasive test would be invaluable in the emergent screening for SAH.In this regard, multisection CT angiography (MSCTA) has shown potential in the noninvasive detection of intracranial aneurysms. Recent literature has demonstrated a high accuracy of detecting aneurysms more than 3–4 mm in size using 4-section (4MSCTA) and 16-section (16MSCTA) in the ranges of 92%–100%, but with a much lower sensitivity in detecting smaller aneurysms (<3–4 mm), in the range of 74%–84%.^9–13 With the advent of newer, faster multidetector CT scanners, there can be thinner collimation, improved z-axis resolution, and contrast bolus timing, potentially leading to improved detection of these smaller aneurysms. Because there has been little literature comparing combined DSA/3DRA with 64-section MSCTA (64MSCTA), our purpose was to evaluate the accuracy of 64MSCTA in aneurysm detection with special attention to smaller (<4 mm) aneurysms.     

Detection and characterization of very small cerebral aneurysms by using 2D and 3D helical CT angiography

BACKGROUND AND PURPOSE: Many cases of subarachnoid hemorrhage are due to rupture of small cerebral aneurysms. Our purpose was to evaluate the usefulness of helical CT angiography (CTA) in the detection and characterization of very small (<5 mm) intracranial aneurysms. METHODS: One hundred eighty consecutive patients underwent CTA for suspected intracranial aneurysms. All aneurysms prospectively detected by CTA were confirmed by digital subtraction angiography (DSA) or at surgery. CT angiograms and digital subtraction angiograms were reviewed by two independent blinded radiologists who performed aneurysm detection, quantitation, and characterization using 2D multiplanar reformatted and 3D volume-rendering techniques. RESULTS: Fifty-one patients harboring 41 very small intracranial aneurysms were included in this series. Eighty-one percent (33 of 41 aneurysms) were 相似文献   

Detection of intracranial aneurysms: multi-detector row CT angiography compared with DSA

PURPOSE: To prospectively compare the effectiveness of multi-detector row computed tomographic (CT) angiography with that of conventional intraarterial digital subtraction angiography (DSA) used to detect intracranial aneurysms in patients with nontraumatic acute subarachnoid hemorrhage. MATERIALS AND METHODS: Thirty-five consecutive adult patients with acute subarachnoid hemorrhage were recruited into the institutional review board-approved study and gave informed consent. All patients underwent both multi-detector row CT angiography and DSA no more than 12 hours apart. CT angiography was performed with a multi-detector row scanner (four detector rows) by using collimation of 1.25 mm and pitch of 3. Images were interpreted at computer workstations in a blinded fashion. Two radiologists independently reviewed the CT images, and two other radiologists independently reviewed the DSA images. The presence and location of aneurysms were rated on a five-point scale for certainty. Sensitivity and specificity were calculated independently for image interpretation performed by the two CT image readers and the second DSA image reader by using the first DSA reader's interpretation as the reference standard. RESULTS: A total of 26 aneurysms were detected at DSA in 21 patients, and no aneurysms were detected in 14 patients. Sensitivity and specificity for CT angiography were, respectively, 90% and 93% for reader 1 and 81% and 93% for reader 2. The mean diameter of aneurysms detected on CT angiographic images was 4.4 mm, and the smallest aneurysm detected was 2.2 mm in diameter. Aneurysms that were missed at initial interpretation of CT angiographic images were identified at retrospective reading. CONCLUSION: Multi-detector row CT angiography has high sensitivity and specificity for detection of intracranial aneurysms, including small aneurysms, in patients with nontraumatic acute subarachnoid hemorrhage.     

Three-dimensional time-of-flight MR angiography for evaluation of intracranial aneurysms after endosaccular packing with Guglielmi detachable coils: comparison with 3D digital subtraction angiography

The sensitivities and specificities of three-dimensional time-of-flight MR angiography (3D-TOF MRA) and 3D digital subtraction angiography (3D-DSA) were compared for evaluation of cerebral aneurysms after endosaccular packing with Guglielmi detachable coils (GDCs). Thirty-three patients with 33 aneurysms were included in this prospective study. 3D-TOF MRA and 3D-DSA were performed in the same week on all patients. Maximal intensity projection (MIP) and 3D reconstructed MRA images were compared with 3D-DSA images. The diameters of residual/recurrent aneurysms detected on 3D-DSA were calculated on a workstation. In 3 (9%) of 33 aneurysms, 3D-TOF MRA did not provide reliable information due to significant susceptibility artifacts on MRA. The sensitivity and specificity rates of MRA were 72.7 and 90.9%, respectively, for the diagnosis of residual/recurrent aneurysm. The diameters of residual/recurrent aneurysms that could not be detected by MRA were significantly smaller than those of detected aneurysms (mean 1.1 vs mean 2.3 mm). In one aneurysm of the anterior communicating artery (ACoA), the relationship between the residual aneurysm and the ACoA was more evident on MRA than DSA images. MRA can detect the recurrent/residual lumen of aneurysms treated with GDCs of up to at least 1.8 mm in diameter. 3D-TOF MRA is useful for follow-up of intracranial aneurysms treated with GDCs, and could partly replace DSA.     

多层螺旋CT三维血管成像在颅内动脉瘤评价中的初步应用--与DSA的对比研究

目的通过与数字减影血管造影(DSA)的对比研究,初步探讨三维CT血管成像(3D—CTA)在颅内动脉瘤评价中的应用价值。资料与方法对24例临床疑有颅内动脉瘤患者进行3D—CTA和DSA。3D—CTA后处理技术包括多平面重建(MPR)、最大信号强度投影(MIP)以及容积重建(VRT)。3D—CTA和DSA分别由相互独立的放射科医师实施和诊断,分别记录动脉瘤的位置、大小、形态以及与周围动脉分支等的关系。同时调查神经外科医师及患者对两种影像手段的认可度。结果3D—CTA发现13例15个动脉瘤,遗漏1个直径1．2mm的动脉瘤,发现的最小动脉瘤长径为1.8mm。DSA发现14例16个动脉瘤。CTA在显示瘤颈以及相邻骨质结构上明显优于DSA,而DSA空间分辨率较高。神经外科医师多认为CTA可以用作颅内动脉瘤的筛查和术前评估,而DSA仍是金标准。患者对CTA的接受度较高。结论3D—CTA是检查颅内动脉瘤高度敏感的无创影像手段,它可以作为颅内动脉瘤筛查和术前评估的首选技术。