多层螺旋CT血管成像诊断脑动脉瘤:与DSA对比研究

目的 探讨16层螺旋CT容积再现脑血管成像技术对脑动脉瘤的诊断价值。方法 对23例临床怀疑脑动脉瘤患者（其中蛛网膜下腔出血者20例）的16层螺旋CT三维血管后处理图像、DsA图像进行回顾性对比研究。CT后重建技术分别采用小视野容积再现技术（shutter volume rendering）、最大密度投影法（M1P）和多曲面重建（MPR），所有CT图像及DSA脑血管造影图像均由两位放射科医生和两位脑外科医生进行双盲法分析评价。结果 16层螺旋CT脑血管成像共检出动脉瘤25个，其中3例为多发性，1例CT血管成像（CTA）结果为阴性，阳性率95．7％（22／23），与DSA比较符合率95．7％（22／23）；16层CTA发现动脉瘤的敏感性为100％（24／24），特异性为100％（1／1），准确性为96．2％（25／26）。CTA对显示瘤体、瘤颈、载瘤动脉与周围血管关系与DSA相比更清晰、确切，并能显示病灶与颅骨结构间的关系，立体感强。结论 16层螺旋CT脑血管成像对脑动脉瘤具有极高的诊断价值，相对无创是诊断脑动脉瘤的最佳影像检查方法，有望替代DSA。

Detection of cerebral aneurysms: multislice CT angiography compared with DSA

Objective To study the significance of 16-slice spiral CT angiography(CTA) in the diagnosis of cerebral aneurysms.Methods Twenty-three cases with suspected cerebral aneurysms(among whom 20 cases with subarachnoid hemorrhage) received CT scan and digital subtraction angiography(DSA).And the results were compared retrospectively.CT posterior reconstructions were carried out by using shutter volume rendering,maximum intensity projection(MIP) and multiplannar reconstruction(MPR).All the images of CTA and DSA were evaluated by two radiologists and two neurologists independently.Results Twenty-five aneurysms were detected by CTA,among which 3 cases had multiple aneurysms and only one case's CTA was negative with 95.7% positive rate(22/23) and coincident rate of 95.7%(22/23) compared with DSA.The sensitivity,specificity and accuracy of CTA in detecting aneurysms were 100%,100% and 96.2% respectively.Compared with DSA,CTA was more clearly and accurate in showing tumor bodies and tumor neck together with the relations between artery with tumors and neighboring vassals and skulls.Conclusion 16-slice CTA has high significance in detecting cerebral aneurysms without invasion.