64层螺旋CT头颈动脉联合成像诊断颅内动脉瘤的应用价值

 目的 评价64层螺旋CT诊断颅内动脉瘤的临床应用价值。方法 选取我院176例颅内动脉瘤患者的头颈CTA(computed tomographic angiography，CTA)检查资料，评价颅内动脉瘤的大小、形态、位置及术后情况。结果 176例均行数字减影血管造影(digital subtraction angiography，DSA)存在动脉瘤(157经手术治疗)，共计 201个动脉瘤，其中19例为多发动脉瘤。首次CTA明确诊断动脉瘤171例(196个)，漏诊5例，阳性诊断率97.5%(196/201)。171例(196个)中颈内动脉瘤112例，后交通动脉瘤10例，前交通动脉瘤26例，基底动脉瘤5例，大脑中动脉瘤13例，大脑前动脉瘤5例，对照DSA再次重组首次漏诊的5例CTA图像，又发现动脉瘤2例，阳性诊断率提高至98.5%。结论 应用多层螺旋CT头颈血管联合成像选择合理的后处理方法，有助于提高图像质量与诊断的准确性，对临床术前评估与术后评价有重要意义。

Application of 64 multidetector CT head and neck angiography in evaluation of intracranial aneurysm

Objective To evaluate the diagnostic value of 64 multidetector-row CT head and neck angiography for intracranial aneurysm. Methods 176 intracranial aneurysm patients were recruited, and evaluated for size, shape, position of the aneurysms by 64 multidetector-row CT head and neck angiography. Results 176 patients were examined by DSA, including 157 post-operative patients. 201 aneurysms were detected, including 19 multiple aneurysms. Of the total, 171 patients were first identified(196 aneurysms), 5 patients missed diagnosis, and the rate of positive diagnosis was 97.5%(196/201). Of the 171 patients, 112 had internal carotid aneurysms, 10 had posterior communicating aneurysms, 26 anterior communicating aneurysms, 5 basilar artery aneurysm, 13 middle cerebral artery aneurysm, 5 anterior cerebral artery aneurysms. Another 2 patients with aneurysms were identified after re-examination. Conclusions The application and rational post-processing of 64 multidetector-row CT head and neck angiography were of significant importance for preoperative postoperative evaluation of intracranial aneurysms.