320排容积CTA对颅内动脉瘤的诊断价值

目的探讨320排容积cT血管成像（CTA）对颅内动脉瘤诊断价值。方法选取医院2010年2月-2013年12月间具有完整颅脑数字减影血管造影（DSA）资料的63例颅内动脉瘤患者，所有患者均于起病3d内完成320排容积CTA检查。以DSA检查结果作为诊断金标准，分析病变的影像学特点，并评价320排容积CTA对颅内动脉瘤诊断的准确性。结果颅脑动脉瘤阳性63例，CTA漏诊1例，病灶位于大脑后交通动脉。320排容积CTA对颅内动脉瘤的诊断敏感度及阳性预测值分别为98．41％、100％。按部位统计动脉瘤数量结果如下：颈内动脉海绵窦段4例，大脑前动脉26例，大脑中动脉4例，大脑后动脉8例，大脑前交通动脉10例，大脑后交通动脉5例，基底动脉6例。动脉瘤瘤径为2～22mm。在CTA上，动脉瘤的瘤体位置、大小、瘤颈、瘤顶指向、载瘤动脉及动脉瘤与邻近血管分支和骨性结构的空间关系均能较满意的显示，均与DSA结果相符。结论320排容积CTA诊断颅脑动脉瘤具有较高敏感性，能准确检出颅内的微小动脉瘤，对动脉瘤的空间解剖关系显示更具优势。因此，在临床工作中，320排容积CTA可以成为颅脑动脉瘤的首选影像学检查方法。

Diagnostic value of 320-slice volume CTA for intracranial aneurysms

Objective To investigate the diagnostic value of 320-slice volume CT angiography （CTA） in intracranial a neurysms. Methods CTA materials of 63 patients of intracranial aneurysms in Guangzhou Medical University affiliated Guangzhou First People＇s Hospital from February 2010 to December 2013 were retrospectively studied. Among these patients, 36 cases were male, 27 were female, aged from 26 to 82 years old, mean age （40 ＋ 2.7） years old. All patients were performed 320-slice volume CTA examination within the 3 days when the clinic symptoms occured, and then underwent DSA examinations. All of the CTA materials were analyzed using DSA results as a diagnostic golden standard. Results There were 63 positive cases. One case with the lesion located in the arteriae communications posterior cerebri was missed by CTA. The diagnositic sensitivity and positive predictive value of 320-slice CTA for the intracranial aneurysms were 98.41% and 100%, respectively. Among all of the intracranial aneurysms, 4 cases located in the cavernous segment of the internal carotid artery, 26 in the anterior cerebral artery, 4 in the middle＇cerebral artery, 8 in the posterior cerebral artery, 10 in the arteriae communicans anterior cerebri, 5 in the arteriae communicans posterior cerebri and 6 in the basilar artery. The diameters of the intracranial aneurysms was 2-22 mm. The locations, sizes, tumor necks, tumor top point, spatial relationships with adjacent blood vessels and bone structure of the aneurysms could be displayed satisfactorily. Volume reconstruction （VR） method was the best method to among all.of the CT reconstruction methods. Conclusion 320-slice volume CTA diagnosis of intracranial aneurysms has a high sensitivity. It can detect small intracranial aneurysm accurately, and has the advantages in revealing the spacial anatomical relationship of aneurysm. Therefore. 320-slice volume CTA could become the first choice for intracranial aneurysms imaging in clinic.