16层螺旋CT血管成像诊断颅内动脉瘤的价值

The value of 16-slice Spiral CT Angiography in Diagnosis of Intracranial Aneurysms

目的:探讨16层螺旋CT血管成像(16SCTA)诊断颅内动脉瘤的价值。方法:对33例16SCTA诊断的颅内动脉瘤进行回顾性分析。其中4例经手术证实,13例经数字减影血管造影(DSA)证实。结果:16SCTA在33例患者中,共发现40个动脉瘤。其中3例为两个动脉瘤,2例为三个动脉瘤。40个动脉瘤中大脑中动脉瘤9个,大脑前动脉瘤8个,大脑后动脉瘤2个,后交通动脉瘤4个,颈内动脉瘤12个,基底动脉瘤3个,胼周动脉瘤1个,小脑上动脉瘤1个。16SCTA均清晰显示瘤体的大小、位置、形态及瘤颈宽度、瘤轴指向、载瘤动脉、动脉瘤与周围重要解剖结构的关系。有DSA资料对照的13例中,16SCTA发现16个动脉瘤中DSA只发现13个,另外DSA发现1个动脉瘤而16SCTA漏诊。16SCTA诊断颅内动脉瘤的敏感度、特异度、阳性预测值、阴性预测值分别为92.9%、97.1%、81.3%、99%。结论:16SCTA在颅内动脉瘤临床诊断和术后随访中有较高的应用价值。

Objective： To assess the diagnostic value of 16-slice spiral computed tomography angiography （16SCTA） in detecting intraeranial aneurysms. Methods： The imaging data of 33 patients with intracranial aneurysms were retrospectively analyzed. 13 patients of them were performed with DSA, and 4 patients were confirmed by operation. Results： In the 33 cases, 40 aneurysms were detected by 16SCTA. Three case had two aneurysms, two case had three aneurysms. The locations of the aneurysm were middle cerebral artery （n=9）, anterior cerebral artery （n=8）, posterior cerebral artery （n=2）, posterior communicating artery （n=4）, carotid（n=12）, basilar artery （n=3）, pericallosal artery （n= 1）, arteria cerebelli superior （n= 1）. 16SCTA can precisely display the size, configuration and direction of in- tracranial aneurysms, and their anatomic connection with surrounding vessels and bones. 16 aneurysms were detected by 16SCTA in the 13 cases in which only 13 were detected by DSA. One aneurysm was detected by DSA but was considered normal by 16SCTA. The sen- sitivity, specificity, positive predictive value and negative predictive value for detection of aneurysms with 16SCTA were 92.9 %, 97.1%, 81.3 % and 99 %, respectively. Conclusion： 16SCTA has important significance in the diagnosis and operation for intracranial aneurysms.