联合应用三维计算机断层和数字减影血管造影诊治颅内动脉瘤

Combined application of combinational three-dimensional CT angiography and DSA in the diagnosis and treatment of intracranial aneurysms.

目的 探讨联合应用三维计算机断层血管造影(CTA)和数字减影血管造影(DSA)诊治颅内动脉瘤的效果。方法 对60例怀疑颅内动脉瘤的患者行CTA和DSA检查,其中1例仅行CTA检查。所有病例再行CTA、DSA检查,将所有检查结果及术中发现做比较。结果 (1)CTA发现55例共56个动脉瘤,9例宽颈,1例多发动脉瘤;DSA发现52例共56个动脉瘤,9例宽颈,4例多发动脉瘤;共治疗53例。(2)9例宽颈动脉瘤,4例手术(2例分别球囊、支架辅助栓塞),4例多发动脉瘤均行手术夹闭,1例载瘤动脉闭塞;43例窄颈动脉瘤,31例电解可脱微弹簧圈(GDC)栓塞,9例夹闭,3例转院。(3)2例仅依据CTA资料行急诊手术,术中发现与CTA检查结果相符。结论 CTA和DSA联合检查有助于颅内动脉瘤的诊断,对治疗方案的选择有重要的指导意义。

Objective To investigate the value of combined application of CTA and DSA in the diagnosis and treatment of intracranial aneurysms. Methods 60 patients who were suspected of intracranial aneurysm were examined by CTA and DSA, one patient was examined by CTA only, then the results of CTA , DSA and surgical findings were analysed. Results (1) CTA demonstrated 56 aneurysms in 55 patients, 9 patients harbored wide-necked aneurysms 2 patients had 2 aneurysms (multiple intracranial aneurysms, MIA); DSA demonstrated 56 aneurysms in 52 cases, 9 patients harbored wide-necked aneurysms 4 patients had 2 aneurysms (MIA); There were 60 aneurysms in 56 patients, and 57 aneurysms in 53 patients were treated by surgery or embolization. (2) There were 43 narrow-necked aneurysms, 31 of them were embolized with GDC, 9 were neck clipped, 3 were treated in other hospitals; There were 9 wide-necked aneurysms, 4 of them were clipped, 4 were embolized with balloon remodeling or stent, 1 was performed parent artery blocking, All the MIAs were clipped. (3)2 cases were underwent emergent surgery just on the basis of CTA, and the results of CTA were conformed with surgery finding. Conclusion The combined application of CTA with DSA is helpful for diagnosis of intracranial aneurysms and has an instructive value in selection of treatment strategy.