CT三维血管减影技术在诊断颅内动脉瘤中的应用

Application of Three-Dimensional Subtraction CT Angiography in Diagnosis of Intracranial Aneurysm

目的探讨CT三维血管减影技术(3D-SCTA)在颅内动脉瘤中的诊断价值。方法23例CT平扫诊断为蛛网膜下腔出血者,采用GE Light Speed16螺旋CT机进行头颅螺旋扫描,先进行平扫,后增强,利用减影软件得到减影后的图像,再利用相关软件进行VR、MIP重建,得到颅内血管的3D、2D图像,然后进行诊断。结果颅底伪影干扰明显减少,显示颅内动脉血管及分支满意。23例21个动脉瘤,3D-SCTA敏感性和特异性均为100%,常规CTA敏感性95.6%,特异性100%。结论3D-SCTA是一种相对无创的血管检查,对颅内动脉及颅内动脉瘤的三维空间形态显示更直观,能满足诊断及临床治疗的需要,有较强的推广价值。

Objective To investigate the diagnostic value of three dimensional subtraction CT angiography （3 DSCTA） in intracranial aneurysm. Method A total of 23 cases of subarachnoic hemorrhage diagnosed by CT plain scanning received head spiral scanning by using GE Light Speed 16. First, plain scanning was performed, the contrasted scanning was obtained with blood injection of contrast media through venous. Then, by using software of subtraction, the images of plain and contrasted scanning were subtracted, in order to gain the new series of imaging. At last,the cranial arteries 3D images with the techniques of volume rendering（VR） and maximum intensity projection（MIP） were obtained by using the software. Results The cranial arteries and their main branches could be displayed in all 23 patients with low interference of basis cranin artefact. Twentyone aneurysms were detected in 23 patients by 3D-SCTA, whose sensitivity and specificity were both 100%, while those in conventional CTA were 95.6% and 100% respectively. Conclusions 3D SCTA is a noninvasire and useful technique for evaluating internal aneurysm, which can provide three-dimensional anatomic information and satisfy the diagnostic and therapeutic demand. It is worthy to be widely applied.