颅内动脉瘤3D-CTA诊断效能的临床研究

目的 评价三维CT血管成像(3D—CTA)在外科治疗颅内动脉瘤中的诊断效能。方法 24例可疑动脉瘤患者行脑血管造影、3D—CTA、MRA和DSA检查。结果 本组共发现28个动脉瘤。21例病人有一个，2例有两个，1例有三个动脉瘤。3D—CTA发现瘤体呈球形为20个、椭圆形5个、分叶形3个。手术暴露的24个动脉瘤，其瘤体形态与3D—CTA发现完全吻合。动脉瘤颈平均直径为5.9mm，最小为1.6mm，最大为13．7mm。根据3D—CTA计算的动脉瘤颈结果与手术发现非常接近。3D—CTA对载瘤动脉和分枝动脉的形态描述明显优于脑血管造影、MRA和DSA。结论 3D—CTA在了解动脉瘤的三维结构和制定手术治疗方案有重要辅助作用。

Diagnostic accuracy of three-dimensional CT angiography in the surgical treatment of intracranial aneurysms

Obje ct ive To evaluate the diagnostic accuracy of three-dimensional CT angiography(3 D-CTA)in the surgical treatment of intracranial aneurysms.Methods Twenty-f our patients suspected with intracranial aneurysms underwent routine four-ve ssel angiography,3D-CTA,MRA or conventional DSA.Results A total of28aneur ysms were detected by CT angiography in this study.A single aneurysm was detec ted in21patients,two patients had two aneurysms,and one had three aneurysm s.The shapes of the aneurysmal bodies revealed by3D-CTA were as follows:20 lesions were round,5were elliptical,and3were lobulated.Among the24lesions ,which were completely disclosed during operation,the shapes correlated well w ith the3D-CTA.According to the3D-CTA images the mean diameter of the aneury smsal necks was5.9mm,the smallest was1.6mm and the largest was13.7mm .The size as calculated from3D-CTA was very close to the actual size at surge ry.3D-CTA correlated well with surgical findings.The relationships of the an eurysms to the parent vessels and other branches were depicted clearly,especi ally compared with images obtained by routine catheter four-vessel angiography ,MRA or DSA.Conclusion3-D CTA enables the surgeon to understand the3-D str ucture of intracranial aneurysms and is very useful in planning the surgical t reatment of cerebral aneurysms.