双能量CT血管造影术在头颈部血管病变诊断中的应用

目的 探讨双能量CT血管造影术(DECTA)在头颈部血管疾病诊断中的临床应用价值.方法 广州军区广州总医院放射科自2009年2月至2009年8月应用DECTA检查疑有头颈部血管病变患者146例,结果阳性患者中16例接受全脑血管造影(DSA)检查.比较DECTA和DSA检查的影像资料及诊断结果.结果 DECTA检查表现正常69例,显示头颈部血管疾病77例(77/146,52.74%).其中15例患者DSA检查显示头颈部血管疾病,与DECTA检查相符(15/16,93.75%),包括动脉瘤8例,颅内动脉、椎动脉局限性狭窄4例,颈动脉粥样硬化并狭窄、颜面部血管畸形和颅内血管畸形各1例.另1例患者CTA检查发现2个小动脉瘤,而DSA检查未发现.结论 DECTA能清晰地显示头颈部血管病变及肿瘤供血动脉,与全脑DSA结果符合率高,对于诊断颈部和颅内血管病变具有较高的敏感性.

Initial clinical application results of dual energy CT angiography on head and cervical vessel diseases

Objective To explore the clinical application value of dual-energy CT angiography (DECTA) for head and cervical vessel diseases. Methods The imaging data and diagnosis results of 146 patients suspected as having head and cervical vascular diseases and underwent DECTA in our hospital from February 2009 to August 2009 were analyzed, retrospectively and compared. Sixteen of them with positive results were also performed whole cerebral vessels DSA. Results Seventy-seven patients (52.74%) were found to have head and cervical vessel diseases under DECTA; 17 patients were diagnosed as having intracranial aneurysm, 13 with carotid artherosclerosis and stenosis, 13 with intracranial and vertebral artery stenosis, 9 with intracranial arteriovenous malformation (AVM), 7 with internal carotid artery (ICA) or vertebral artery occlusion, 4 with neck-face AVM, 3 with Moyamoya disease, 3 with intracranial tumors, 2 with cerebral infarction, 2 with intracranial phlebothrombosis, 1 without imaging in bilateral ICA, 1 with Sturg-Webber syndrome and 1 with primitive trigeminal artery.DSA results were concordant with the DECTA results by finding 15 of 16 patients (93.75%) with head and cervical vessel diseases; 8 patients were detected as having intracranial aneurysm, 4 with ICA or vertebral artery occlusion, 1 with carotid artherosclerosis and stegnosis, 1 with intracranial AVM and 1 with neck-face AVM. The one that DSA did not find any tumors was noted as having 2 microaneurysms by CTA. Conclusion The head and cervical vascular diseases and the feeding artery of tumor can be demonstrated distinctly with DECTA with high diagnosis accuracy and sensitivity.