64排螺旋CT血管造影诊断颅内动脉瘤

目的探讨64排螺旋CT血管造影(CTA)诊断颅内动脉瘤的临床价值。方法对52例怀疑颅内动脉瘤的患者行头部64排螺旋CTA检查,层厚0.625mm,后处理技术包括多层面重建、表面遮盖三维重建、容积显示重建及最大密度投影重建,并对照开颅手术及介入栓塞治疗结果,评估其诊断准确性。结果64排螺旋CTA共发现48例患者50个动脉瘤,其中46例为单发动脉瘤,2例为2个动脉瘤。动脉瘤最小直径2.2mm,最大直径43mm。64排螺旋CTA能清晰显示动脉瘤的瘤体大小、瘤颈、瘤顶指向、载瘤动脉及动脉瘤与邻近血管和骨性组织间的解剖关系。手术证实的动脉瘤与64排螺旋CTA显示的动脉瘤符合率为100%,数字减影血管造影(DSA)证实的动脉瘤与64排螺旋CTA显示的动脉瘤符合率为97.2%。结论64排螺旋CTA诊断颅内动脉瘤有较高的准确性,在诊断颅内动脉瘤时,可对DSA起到重要补充作用。

Diagnosis of intracranial aneurysm with 64-slice spiral CT angiography

Objective To discuss the clinical application value of 64-slice spiral CT angiography(CTA)in the diagnosis of intracranial aneurysm.Methods Fifty-two patients suspected with intracranial aneurysms were examined with 64-slice spiral CTA,and the slice thickness was 0.625 mm.The postprocessing techniques included multi-plane reconstruction,shade surface display 3-D reconstruction,volume rendering and maximum intensity projection,and their accuracy of diagnosis were evaluated with the results of craniotomy and embolotherapy.Results A total of 50 aneurysms were detected by 64-slice spiral CTA in 48 patients.Among them,46 patients had single aneurysms,and two patients had 2 aneurysms.The smallest diameter of aneurysm was 2.2 mm,and the largest was 43 mm.64-slice spiral CTA could clearly show the size,neck and axis pointing of the aneurysms,as well as the relationship with the surrounding anatomic structures.The coincidence of aneurysms confirmed by operation and those detected by 64-slice spiral CTA was 100%,and the coincidence of digital subtraction angiography(DSA)confirmed with those detected by 64-slice spiral CTA was 97.2.Conclusion The accuracy of 64-slice spiral CTA is higher in the diagnosis of intracranial aneurysm,and it can be used as an important supplement to DSA in the treatment of intracranial aneurysm.