颈动脉假性动脉瘤的血管造影诊断

Angiographic diagnosis of the carotid artery pseudoaneurysm

目的 探讨颈动脉假性动脉瘤的血管造影表现及诊断价值。方法 由 2名有经验的放射学医师按双盲法对 16例颈动脉假性动脉瘤的血管造影及临床资料进行回顾性分析 ,然后共同讨论并达成一致意见。结果 16例患者经血管造影均能明确诊断 ,动脉瘤位于颈总动脉者 1例 ,颈动脉分叉处 9例 ,颈内动脉 5例 ,颈外动脉 1例。血管造影主要表现为瘤腔内造影剂滞留 (12例 ) ,瘤腔内形成涡流 (9例 ) ,动脉瘤开口处“喷射征”(7例 ) ,颈动脉分叉角度增大 ,颈内、外动脉移位 (9例 )。结论 血管造影是诊断颈动脉假性动脉瘤最有价值的检查方法 ,其不但可明确诊断 ,而且有利于临床治疗方式的选择。

Objective To create a further understanding of the angiographic features of the carotid artery pseudoaneurysm (CAPA) and to explore the clinical diagnostic value of angiography.Methods Sixteen cases of CAPA with clinical and angiographic data were analyzed retrospectively. The angiographic appearances in all of the patients were observed dynamically and precisely with a double blind method by two experienced radiologists together and formed a consensus interpretation. Results Angiography provided a definite diagnosis for all cases. The parent arteries included the common carotid artery (1 case), common carotid artery bifurcation (9 cases), internal carotid artery (5 cases) and external carotid artery (1 case). The angiographic features of the CAPA were: All cases showed the contrast media retension in the aneuysms; turblulent flow within aneurysm in 9 cases; the “jetting sign” at the leak of the parent artery in 7 cases; increase angulation of the bifurcation of internal and external carotid arteries in 12 cases.Conclusions Angiography is the most valuable examination method in diagnosis of CAPA, and it can not only provide definite diagnosis, but also play an important role in selection of therapeutic plan.