MSCTA在颅内动脉瘤诊断中的应用及质量控制

Diagnostic evaluation and quality control of intracranial aneurysm with multi-slice CT angiography

目的探讨多层螺旋CT血管成像(MSCTA)对颅内动脉瘤的诊断价值以及其质量控制。方法收集经数字减影血管造影(DSA)和手术证实的颅内动脉瘤27例,所有的病例均行多层螺旋CT血管成像。采用容积再现(VR)、最大密度投影(MIP)和曲面重建(CPR)等方法进行图像重建。19例行手术治疗,8例行DSA检查。结果27例患者均单发,MSCTA发现动脉瘤24个,其中大脑中动脉10个,大脑前动脉7个,大脑后动脉4个,颈内动脉2个,椎动脉1个。3例颈内动脉瘤漏诊。MSCTA上动脉瘤显示直径5～22mm。手术及DSA所见与CT动脉造影CTA所显示动脉瘤位置、大小、形态基本一致。结论MSCTA能清楚显示颅内动脉瘤的形态、位置及其与周围的解剖关系,为手术或介入治疗动脉瘤提供非常有价值的信息。

Objective To evaluate the values and quality control of multislice CT angiography （MSCTA） in the diagnosis of cerebral aneurysms. Methods MSCTA were performed in 27 patients with cerebral aneurysms confirmed by DSA and operation. CTA were processed with maximum intensity projection （ MIP ） , volume rendering （VR） and curved planar reformation （CPR）. 8 cases were performed DSA and 19 cases were performed operation. Results All the cases are solitary. 24 cerebral aneurysms in 27 patients were found in MSCTA, 10 aneurysms were in the middle cerebral artery, 7 in the anterior cerebral artery, 4 in the posterior cerebral artery, 4 in the internal carotid artery and 1 in the vertebral artery. 3 aneurysms in the internal carotid artery were missed on the MSCTA. The diameter were between 5 - 22 mm on MSCTA images. The location, size and appearance of cerebral aneurysms showed in MSCTA images were in accordant with the result of DSA and operations. Conclusion MSCTA can display clearly the location, size and appearance of cerebra aneurysms accurately and objectively, and provide valuable information for surgery or iuterventional therapy.