CT血管造影诊断破裂脑动脉瘤

Diagnosis of ruptured cerebral aneurism with computerized tomography angiography

目的探讨运用CTA诊断破裂脑动脉瘤。方法对怀疑颅内动脉瘤破裂的40例病人施行CTA检查,采用Philips Tomoscan AVP1螺旋CT机,数据经计算机工作站处理后以最大密度投影重建(MIP)和表面遮盖法重建(SSD)法显示,由放射科医师和神经外科医师共同阅片。结果本组40例病人共检出25例28个动脉瘤,其中前交通动脉瘤13例,颈内动脉颅内段动脉瘤3例,后交通动脉瘤2例,大脑中动脉瘤2例,眼动脉瘤1例,基底动脉梭形动脉瘤1例,左侧大脑中动脉瘤破裂合并右侧颈内动脉瘤1例,后交通动脉瘤合并同侧颈内动脉床突周围段芽孢状微小动脉瘤2例。20例脑动脉瘤做了开颅手术治疗,其中15例单纯根据CTA检查结果手术,术中证实诊断。结论CTA具有快速、简便、安全、可靠的优点,可作为破裂脑动脉瘤和急诊手术前首选的检查。

Objective To evaluate the value of computerized tomography angiography （CTA） for the diagnosis of ruptured cerebral aneurism. Methods Forty patients on suspicion of ruptured cerebral aneurism had CTA with the Philips Tomoscan AVPI spiral CT . The imagines displayed with the techniques of maximum intensity projection （MIP） and the shaded surface display （SSD） after the data proceeded by computer station were read both by radiology physician and neurosurgeon. Results Twenty-eight aneurysms were found in 25 cases in 40 cases studied, including 13 cases of anterior communicating arterial aneurysm （ACoA）, 3 case of intracranial carotid arterial aneurysm, 2 case of posterior communicating arterial aneurysm （PCoA）, 2 case of middle cerebral arterial aneurysm （MA）, 1 case of ophthalmic arterial aneurysm, l case of basilar arterial aneurysm （BA）, l case of left middle cerebral artery aneurysm （MCA） and 2 cases of PCoA accompanied with minimum sprout-like aneurysm at collateral paraclinoid carotid artery. Twenty patients had craniotomy for clipping their aneurysms. Fifteen cases were operated without conventional cerebral angiography after CTA, in which all the finding were identical with preoperative examination. Conclusion CTA may be a quick, relative simple, safe and reliable tool of choice for the diagnosis and emergency treatment of ruptured aneurysm.