16层螺旋CT血管造影在颅内动脉瘤破裂中的临床应用

目的通过与DSA和手术对照，探讨16层螺旋CT血管造影（CTA）在颅内动脉瘤破裂的临床应用价值。资料与方法对33例动脉瘤性蛛网膜下腔出血（SAH）、脑出血患者进行回顾性分析，33例均使用16层螺旋CT进行了CTA检查，其中18例行DSA检查；6例DSA下介入治疗，27例开颅行动脉瘤颈夹闭术；将CTA与DSA和术中所见对照。结果33例中，CTA共发现动脉瘤36个，其中18例行DSA检查者中，CTA发现动脉瘤20个，DSA发现动脉瘤21个；CTA能够清晰显示动脉瘤瘤体（形态、指向、轮廓）、瘤颈的宽度、载瘤动脉及与颅骨之间的关系；与DSA和手术对照，CTA对动脉瘤的检出率为95．2％，对破裂动脉瘤的诊断敏感性和特异性均为100％。结论16层螺旋CT脑血管造影重组图像质量高，安全、快速、无创，可以作为颅内动脉瘤破裂首选的筛检方法。

Clinical Application of 16-slice CT Angiography in Acute Ruptured of Cerebral Aneurysm

Objective To evaluate the value of 16-slice CT angiography(CTA) in detecting ruptured intracranial aneurysms compared with digital subtraction angiograghy(DSA) and surgery.Materials and Methods 33 patients presented with subarachnoid hemorrhage(SAH) and/or intracranial hemorrhage were reviewed,all patients were received CTA,among them,18 patients were performed by DSA,6 patients were received endovascular therapy,27 patients were treated with aneurysms clip.The DSA and surgical findings acted as a standard controlled procedure.Results Of 36 aneurysms verified with DSA and surgery in 33 patients,21 aneurysms were verified with DSA in 18 patients,20 aneurysms by CTA.The body of aneurysms(including morphology,outline and the develop orientation)were demonstrated on CTA,the characteristics of the aneurysm including neck size,width,the relationship to surrounding vessels and its space relations with the skull were also well displayed.The sensitivity for detecting aneurysm were 95.2%,however for ruptured aneurysm diagnostic sensitivity and specificity were 100%.Conclusion The 16-slice CTA is a safe,quick and noninvasive method in detecting ruptured intracranial aneurysm.