16层螺旋CT血管成像对脑动静脉畸形的诊断和应用价值

Diagnostic accuracy and clinical application of 16-slice CT angiography in cerebral arteriovenous malformations

目的:评价16层螺旋CT三维重建技术对脑动静脉畸形(AVM)诊断的准确性和临床应用价值。方法:对70例临床怀疑AVM的16层螺旋CT三维血管后处理图像和数字减影血管造影(DSA)图像进行回顾性对比研究。CT后处理技术分别为容积再现技术(VR)、最大密度投影法(MIP)和表面遮盖法(SSD)。结果:70例患者中,17例发现AVM,24例发现脑动脉瘤和3例发现烟雾病,26例CTA和DSA检查阴性。17例AVM患者的16层螺旋CT三维血管图像上均见到典型的畸形血管团,16例发现供血动脉(94%),15例可见引流静脉(88%)。结论:16层螺旋CTA对于AVM检出具有很高的准确性,它在AVM的筛选、诊断和治疗方案的制定方面可以替代常规DSA检查。

Objective：To assess the diagnostic accuracy and clinical application of three-dimensional （3-D） 16-slice CT angiography （CTA） in detecting cerebral arteriovenous malformations （AVM）. Methods ：70 cases suspected cerebral AVM received CT scan and digital subtraction angiography（DSA）,and the results were compared retrospectively. CT posterior reconstructions were carried out by using volume rendering （VR）, maximum intensity projection （MIP） and shaded-surface display （SSD）. Results ： 17 of 70 patients had cerebral AVM,24 patients had cerebral aneurysms,three patients had moyamoya disease,and 26 patients were negative. In 17 AVM patients,all patients found malformated vessel masses, 16 patients clearly displayed feeding arteries and 15 patients demonstrated draining veins in 3-D 16-slice CTA images. Conclusion： 16-slice CTA has a very high accuracy of detecting AVM. 16-slice CTA is sensitive enough to replace conventional DSA in the triage,diagnosis, and treatment planning in patients with cerebral AVM.