三维CT血管造影在颅内动脉瘤诊治中的应用研究

Clinical exploratory development of three-dimensional CT angiography(3D-CTA) in the diagnosis and treatment of intracranial aneurysms

目的探讨三维CT血管造影(3D-CTA)在颅内动脉瘤诊治中的应用价值。方法对62例怀疑动脉瘤破裂的自发性蛛网膜下腔出血患者均行CTA检查,根据患者CTA检查情况及患者的病情及经济情况分别采用动脉瘤夹闭术或栓塞术,术中进一步观察动脉瘤的部位、数量、大小、瘤体指向、与载瘤动脉的关系等。对CTA检查阴性的患者进一步行DSA检查。结果该组62例患者中有56例共发现动脉瘤63个,其中34例36个动脉瘤行夹闭治疗,19例22个动脉瘤行栓塞术,夹闭术中及栓塞术中所见动脉瘤的部位、数量、大小、瘤体指向、与载瘤动脉的关系均与CTA影像相一致。该组3D-CTA对颅内动脉瘤的诊断准确率为96.9%(63/65),假阴性率为3.1%(2/65)。结论3D-CTA能够清楚地显示颅内动脉瘤的部位、数量、大小、形态、瘤体指向、瘤颈情况、与载瘤动脉的关系,可作为颅内动脉瘤诊断的首选检查方法。

[ Objective ]To study the clinical value of three-dimensional CT angiography （3D-CTA） in the diagnosis and treatment of intracranial aneurysms. [ Methods ] 62 patients with suspected to the ruptured aneurysms who displayed spontaneous subarachnoid hemorrhage （SAH） on CT imaging were all examined with 3D-CTA. We performed clipping and embolizating respectively on them who be found having aneurysms on the basis of 3D-CTA examination and patient＇s condition and economy, and observed aneurysm＇s location, quantity, magnitude, direction, as well as relation to the artery carrying aneurysm. The others who not be found having aneurysms were examined with DSA again. [Results] In all 62 cases, a total of 63 aneurysms were detected in 56 cases. Among the total, 34 patients with 36 aneurysms were processed on clipping and 19 patients with 22 aneurysms on embolizafing respectively. The surgery aneurysm＇s location, quantity, magnitude, direction, relation to the artery carrying aneurysm discovered in clipping and embolizating were same as 3D-CTA Results. In this group, the accurate rate of 3D-CTA in the diagnosis of intracranial aneurysms was 96.9% （63/65）, the fake negative rate was 3.1% （2/65）. [ Conclusions] 3DCTA can display intracranial aneurysm＇s location, quantity, magnitude, shape, direction, neck of aneurysms, as well as relation to the artery carrying aneurysm. 3D-CTA should be regard as the first choice for diagnosing intracranial aneurysms.