64层3D-CTA与3D-DSA对颅内动脉瘤评价的对比研究

目的 对比评价64层螺旋CT三维血管造影(3D-CTA)与三维数字减影血管造影(3D-DSA)对颅内动脉瘤的诊断价值.方法 28例临床怀疑颅内动脉瘤的患者均行64层螺旋CT血管造影和DSA,CT三维后处理主要包括容积重建(VR)及最大密度投影(MIP).常规二维DSA检查后,对可疑病变血管行旋转DSA检查,应用三维工作软件行3D后处理,比较3D-CTA与3D-DSA对动脉瘤显示的价值.结果 28例病例中22例CTA和DSA均显示动脉瘤并经手术或栓塞证实,其中1例CTA和DSA显示单个动脉瘤,手术证实为2个动脉瘤,1例CTA显示假阳性.3D-CTA与3D-DSA均能清楚显示动脉瘤形状、瘤径指向、瘤体直径、瘤颈、载瘤动脉、瘤体穿动脉情况,两者无明显差异.结论 64层3D-CTA在颅内动脉瘤诊断及细节显示上与3D-DSA无明显差异,一定程度上应能替代血管造影,指导临床治疗.

Comparative Study on 64-slice 3D-CTA and 3D-DSA in the Diagnosis of Intracranial Aneurysm

Objective To compare the values of 64 -slice 3 - dimension computed tomography angiography (CTA) and 3 -dimension digital subtraction angiography (DSA) in diagnosis of intracranial aneurysm. Methods 28 patients suspected clinically with intracranial aneurysms underwent 64 -slice CTA and 3D - DSA. The post - processing of CTA included volume reconstruction (VR), maximum intensity projection(MIP). After conventional 2D-DSA, rotational DSA was performed, the VR images were obtained from 3D reconstruction workstation. The informations of aneurysms about number, positon, shape, direction, diameter, calcification ,aneurysm neck,children aneurysms,surrounding structures and parent artery etcetera were compared between 3D-CTA and 3D-DSA. Results 24 aneurysms were found in 22 patients by CTA and DSA and confirmed by operation or embolic therapy. One patient was identified having 2 aneurysms by operation, while only one aneurysm showed by CT and DSA. False positive sign of aneurysm was showed by CTA in one case. There was no significant difference in accuracy of diagnosis about the details of aneurysms such as shape, direction,diameter etcetera between 3D-DSA and 3D-CTA. Conclusion 64 -slice 3 -dimension computed tomography angiography(CTA) and 3 -dimension digital subtraction angiography (DSA) are of the similar value in the diagnosis of intracranial aneurysm,so CTA may be a good substitution of DSA in certain degree.