CT血管成像诊断脑动脉瘤的漏诊原因分析

目的:分析CT血管成像(CTA)在脑动脉瘤诊断中漏诊的原因,进一步提高头部CTA的检查和诊断能力.方法:搜集同时行CTA和DSA检查的脑动脉瘤患者病例资料36例,DSA用Philips-HM3000数字减影机,CT用GELight-speed及Philips Brilliance 16层CT机进行扫描,层厚0.625～1.250 mm.在工作站上进行脑血管后处理重组,诊断结果与DSA相对比.结果:经DSA证实的36例脑动脉瘤,初次CTA诊断明确32例,漏诊4例.对照DSA回顾性分析,再次行VR重组,CTA又找到动脉瘤2例,而4例瘤体直径均小于3 mm.结论:头部CTA诊断脑动脉瘤仍存在一定的局限性,合理的扫描方法和细致的观察有助于减少漏诊,提高诊断的准确性.

Analysis of Missed Diagnosis of Cerebral Aneurysm in Head Computed Tomography Angiography

Objective:To analyse the reason of missing of cerebral aneurysm and further improve the ability of examination and diagnosis in head computed tomography angiography (CTA).Methods:Thirty-six patients with cerebral aneurysms were examined with CTA and DSA.Reconstruction images were processed at the workstation.We compared the CTA results with those of DSA.Results:Among thirty-six cases,two aneurysms were not displayed in CTA,which were demonstrated in DSA.Two aneurysms were missing,which were demonstrated after the review of reconstruction.All these four aneurysms were less than 3mm in diameter.Conclusion:There are still certain limitations in the diagnosis of cerebral aneurysm by head CTA.Reasonable scanning and careful observation are helpful to avoid the missing of lesions and improve the diagnostic accuracy.