颅内动脉瘤的MSCTA诊断

目的:探讨64层螺旋CT血管成像(64-MSCTA)对颅内动脉瘤的诊断价值。方法:搜集经DSA和手术证实的颅内动脉瘤18例,所有的病例均行64层螺旋CT血管成像。分别用最大密度投影(MIP)、容积再现(VR)、多平面重组(MPR)法进行图像重组。13例行手术治疗,5例行DSA检查。结果:18例患者中MSCTA发现动脉瘤17个,其中大脑中动脉7个,大脑前动脉6个,大脑后动脉2个,颈内动脉2个。1例左侧颈内动脉瘤MSCTA漏诊,经DSA检查发现。MSCTA上动脉瘤显示直径3～20mm。MSCTA所发现的17个动脉瘤与手术及DSA所见的动脉瘤位置、大小、形态基本一致。结论:MSCTA能清楚显示颅内动脉瘤的形态、位置及其与周围的解剖关系,为手术或介入治疗动脉瘤提供有价值的信息。

Diagnosis of Intracranial Aneurysm with 64-slice CT Angiography

Objective:To evaluate the value of 64-slice CT angiography(MSCTA)in the diagnosis of intracranial aneurysm.Methods:18 patients with 18 intracranial aneurysms confirmed by DSA and surgery had MSCTA.The MSCTA data of these 18 patients were processed with maximum intensity projection(MIP),volume rendering(VR)and multiplanar reconstruction(MPR).DSA was performed in 5 cases and surgery was undertaken in 13 cases.Results:17 cerebral aneurysms were detected in these 18 patients by MSCTA,with aneurysm located at middle cerebral artery(n=7),anterior cerebral artery(n=6),posterior cerebral artery(n=2)and internal carotid artery(n=2).1 aneurysm located in left internal carotid artery was found by DSA,yet was missed by MSCTA.The diameter of aneurysm ranged from 3~20mm on MSCTA images.The location,size and shape of these 17 cerebral aneurysms showed on MSCTA were in accordance with the result of DSA and/or surgery.Conclusion:MSCTA can display clearly the location,size and shape of intra-cranial aneurysm as well as their relationship with the adjacent anatomic structures,which provide valuable information for surgery or interventional therapy.