三维CT血管造影在颅内动脉瘤诊断和治疗中的应用

Application of 3D-CTA in diagnosis and therapy of intracranial aneurysms

目的评价三维CT血管造影(3D-CTA)在颅内动脉瘤破裂后蛛网膜下腔出血诊断中的价值及其对手术的指导意义。方法对136例蛛网膜下腔出血患者行螺旋CT检查,将数据输入工作站行图像三维重建。对其中95例行数字减影血管造影术(DSA)检查,41例直接手术证实。结果3D-CTA显示了瘤体的大小、方向,以及与载瘤动脉、邻近血管及骨质结构的相互关系;经手术、DSA证实本组3D-CTA对动脉瘤的诊断准确率为98.4%。假阳性率为1.6%,假阴性率为0。结论3D-CTA对颅内动脉瘤是一种无创、快速、高准确率的诊断技术;3D-CTA可显示各部位动脉瘤与载瘤动脉、邻近动脉分支及邻近颅骨的空间关系,对选择手术入路和手术方式有较大的帮助。

Objective To assess the value of three dimensional CT angiography （3D-CTA） in diagnosis and therapy of intracranial aneurysms. Methods After diagnosed as subarachnoid hemorrhage （SAH）, 3D-CTA of 136 patients were reconstructed. DSA was performed in 95 patients, while 41 patients were proved by operation. Results 3D-CTA showed clearly the size of aneurysms and its spatial relationship with origin arteria, adjacent branch arteria and Cranii. Accurate rate of 3D-CTA diagnosis for aneurysms was 98.4% with a false positive rate of 1.6% and a false negative rate of 0. Conclusion 3D-CTA is a noninvasive, fast and accurate technique for intraeranial anettrysm diagnosis. 3D-CTA shows the spatial relationship between the aneurysms and origin arteria, adjacent branch arteria and Crarlii clearly, which is helpful for final decision of operative approach and manner.