三维螺旋CT血管造影在颅底肿瘤手术前评估中的应用

目的初步评估三维螺旋CT血管造影(3D-SCTA)在颅底肿瘤手术前的应用价值。方法对19例CT、MRI临床证实为颅底肿瘤患者采用多层面螺旋CT血管造影检查,采用表面遮盖法(SSD)和最大密度投影法(MIP)行3D图像重建,12例行伪彩SSD重建用以模拟手术入路,同期10例行核磁共振血管造影(MRA)和脑数字减影血管造影(DSA),7例行神经导航手术前规划及术中导航。结果3D-SCTA能清楚显示颅底肿瘤的形态及其与邻近大血管、颅骨的三维关系,为手术前选择手术入路提供了重要信息。结论3D-SCTA提供了颅底肿瘤与邻近血管和颅骨的三维空间图像,为常规二维影像的补充,对颅底肿瘤手术前评估有重要价值。

Clinical application of three-dimensional spiral computed angiography in preoperative evaluation of skull base neoplasm

Objective To evaluate the clinical value of three-dimensional spiral computed angiography(3D-SCTA) in the preoperation of the skull base neoplasm. Methods 19 patients with the skull base neoplasm confirmed by CT and MRI were examined with multislice spiral computed angiography. The surface shaded display (SSD) and maximum intensity projec-tion(MIP) technique were used to reconstruct the 3D images in all cases,the color SSD 3D-images were used to imitate the approach of operation in 12 cases. 10 cases with the skull base neoplasm underwent magnetic resonance angiography(MRA) and digital subtraction angiography(DSA) at the same time. Neuronavigation was used to provide preoperative plan and operative localization in 7 cases.Rusults 3D-SCTA clearly showed the 3D shape of the neoplasm and the relationship with the adjacent vessels and the skull base, also supplied vital information to choose the proper operative approach. Conclusions As an important supplement to conventional 2D imagines,3D-SCTA can provide 3D imagings of the neoplasm, adjacent vessels and the bones in the skull base. It has a great value in preoperative evaluation of the skull base neoplasm.