16层CT血管造影在颅内动脉瘤诊断及术后评价中的应用

目的探讨16层螺旋CT血管造影(CTA)对颅内动脉瘤的诊断价值,以及对动脉瘤夹闭术后评价其指导价值.资料与方法回顾性分析23例临床怀疑为颅内动脉瘤,并进行了16层CTA和DSA检查的病例,以DSA作为参考标准,评价16层CTA诊断价值.搜集6例动脉瘤钛夹夹闭病例进行术后评价,术前术后均进行了CTA检查,通过比较两次CTA结果评价动脉瘤夹闭情况.结果根据DSA资料及手术结果,16层CTA发现颅内动脉瘤的敏感性为81.5%,特异性为100%,准确性为84.4%.6例动脉瘤钛夹夹闭术后CTA随访中,与术前CTA相比,颅内大血管均未见狭窄或闭塞,但1例可见较为明显的瘤体残留.结论 16层CTA诊断颅内动脉瘤具有较好的特异性和敏感性,以及较好的三维显示能力,具有一定的临床应用价值.但对颈内和椎动脉动脉瘤,CTA仍然存在着一定困难.在动脉瘤夹闭术后评价方面,CTA能够清楚地显示瘤夹位置及载瘤动脉的通畅程度,但对于判断瘤颈及瘤体残留方面,其准确性有待DSA的进一步证实.

Application of 16 Slices CT Angiography in the Diagnosis and Postoperative Evaluation of Intracranial Aneurysms

Objective To assess the values of 16 slices CT angiography (CTA) in the diagnosis and postoperative follow-up of intracranial aneurysms after clip.Materials and Methods 23 patients were admitted under clinical symptoms and signs suggestive of harboring intracranial aneurysms. All these patients were underwent CTA and DSA examinations. DSA was used as gold standard. 6 patients who had been treated with clip were underwent both preoperative and postoperative CTA to evaluate aneurysm clipping.Results According to DSA results and surgical findings, the sensitivity, specificity, and the accuracy of 16 slices CTA for the detection of all aneurysms were 81.5%, 100%, and 84.4% respectively. Postoperative CTA displayed a remnant of the aneurysm body in one case, and all the parent artery and other major artery are patency.Conclusion 16 Slices CTA has satisfying sensitivity and specificity, but CTA has limitation in internal carotid artery and vertebral artery. After aneurysm clipping, CTA can evaluate clip position, the patency of the parent vessel and other major vessel, but the value of evaluating the presence of remnant of aneurysm body and neck need further research.