64排螺旋CT血管成像在颅内动脉瘤诊断中的价值

目的     探讨64排螺旋CT血管成像(64-SCTA)诊断颅内动脉瘤的临床价值。 方法　回顾性分析82例颅内动脉瘤患者的头颈部64-SCTA检查的多平面重组、容积再现及最大密度投影图像,并与开颅手术及介入栓塞治疗结果对比,评价64-SCTA诊断动脉瘤的准确性。结果　82例患者中,　64-SCTA共发现94个动脉瘤,其中87.8%为单发动脉瘤,9.8%有2个动脉瘤,2.4%有3个动脉瘤。　64-SCTA能清晰显示动脉瘤的瘤体大小、瘤颈、瘤顶指向、载瘤动脉及动脉瘤与邻近血管和骨性组织间的解剖关系。以手术及DSA为标准,64-SCTA漏诊3个动脉瘤,1个动脉瘤为假阳性。64-SCTA检测颅内动脉瘤的敏感性和准确性分别为96.9% 和96%。 结论　64-SCTA是一种快速、无创、准确地检查手段,可作为颅内动脉瘤的首选及常规检查方法,能够提供足够的信息指导动脉瘤的治疗。

Diagnostic value of 64-slice CT angiography on intracranial aneurysm

Objective　To discuss the clinical application value of 64-slice computed tomography angiography (64-SCTA) on the diagnosis of intracranial aneurysms． Methods　The multiplane reformation images, volume rendering and maximum intensity projection images of 64-SCTA of 82 intracranial aneurysms patients were evaluated retrospectively. The diagnostic accuracy of 64-SCTA in the detection of intracranial aneurysms were evaluated using the results of craniotomy and embolotherapy as "gold" standard． Results　In 82 patients, 94 aneurysms were detected by 64-SCTA (1 aneurysms for 72 patients,2 aneurysms for 8 patients, and 3 aneurysms for 2 patients)．64-SCTA could clearly show the size,neck and apex pointing of the aneurysms, as well as the relationship with the peripheral structures． Compared with the results of craniotomy and embolotherapy, 1 false positive, and 3 false negatives were identified by SCTA, which implied that its sensitivity and accuracy were 96.9% and 96%, respectively. Conclusions　 64-SCTA appears as a fast, non-invasive and accurate examination that can be used as an optimal and routine study of intracranial aneurysm. It provides enough anatomical information for treatment planning.