颅内动脉瘤的多层螺旋CT血管成像评估（附62例报道）

目的探讨多层螺旋CT血管成像（multi-slice computed tomography angiography, MSCTA）诊断颅内动脉瘤的价值：方法对62例临床怀疑为颅内动脉瘤患者的进行MSCTA检查，并与DSA和手术结果进行对照和分析。结果在62例患者中，MSCTA检出动脉瘤其66个，7例未检见动脉瘤，其中9例为多发动脉瘤，2个瘤灶者7例，3个瘤灶者2例。动脉瘤位于前交通动脉者26个，大脑中动脉15个，颈内动脉12个，大脑前动脉4个，后交通动脉4个，小脑后下动脉3个，基底动脉2个。最大瘤体直径为18mm，最小瘤体直径2mm。经DSA和手术对照，MSCTA诊断准确55例，漏诊3例，动脉瘤位置判断不准3例，假阳性1例。MSCTA诊断动脉瘤敏感性883％，特异性100％，准确率91．7％，阳性预测值97.0％，阴性预测值71．4％。结论MSCTA可安全、快捷、无创性血管成像，能清晰显示颅内动脉瘤瘤体（形态、大小、指向、轮廓）、瘤颈宽度、载瘤动脉及与颅骨之间的关系，推荐作为颅内动脉瘤检查的主要方法之一。

Evaluation of intracranial aneurysm by multi-slice computed tomography angiography

Objective To evaluate the application of MSCTA in detecting intracranial aneurysm. Methods 62 patients who were suspected to be intracranial aneurysm took MSCTA examination,and the results were compared with surgical finding and digital subtraction angiography（DSA）. Results 66 intracranial aneurysms were detected while no aneurysm was detected in 7 cases. Of the 9 cases in whom multiple aneurysms were detected, 7 cases had two aneurysms and 2 cases had three aneurysms. 26 intracranial aneurysms were located in anterior communicating artery, 15 in middle cerebral artery, 12 in internal carotid artery,4 in anterior cerebral artery, 4 in posterior communicating artery, 3 in posterior inferior cerebella artery, 2 in basilar artery. The maximum aneurysm body diameter was 18ram, and the minimum is was 2ram. After verification of surgical finding and DSA examination, 55 cases were correctly diagnosed with 3 cases missed, 3 cases of incorrect position and 1 false positive case. Overall sensitivity,specificity and accuracy of MSCTA in detecting intracranial aneurysm were 88.3%, 101）%,＇ and 91.7%, respectively, with positive and negative predictive values of 97.0% and 71.4%. Conclusion The MSCTA is a safe, quick and noninvasive method in detecting intracranial aneurysm. The body of aneurysms （including morphology outline and the develop orientation） are demonstrated on MSCTA. The characteristics of aneurysm including neck size, width, relationship to surrounding vessels and its space relation with the skull are also well displayed. It is a useful method in detection ofintracranial aneurysms.