16层螺旋CTA对颅内动脉瘤的诊断价值及术后评价

Application of 16-slice spiral CT angiography in diagnosis and post-operative evaluation of intracranial aneurysms

目的:探讨16层螺旋CTA对颅内动脉瘤的诊断价值,以及开颅夹闭术后随访中的应用价值。方法:回顾性分析经手术及经动脉数字减影血管造影(digital subtraction angiography,DSA)证实的颅内动脉瘤患者38例,所有病例采用16层螺旋CTA检查,运用容积重建和最大密度投影两种后处理技术评价动脉瘤的大小、形态、位置及周围结构的关系,观察动脉瘤夹闭术后的显示情况。结果:本组38例患者,CTA检出42个动脉瘤,其中2例为2个动脉瘤,1例为3个动脉瘤。后交通动脉瘤20例,前交通动脉瘤10例,大脑中动脉瘤6例,颈内动脉颅内段动脉瘤5例,椎动脉瘤1例。其中囊状动脉瘤28个,梭形动脉瘤8个,不规则状动脉瘤6个,直径约2～23 mm,平均直径约为5.8 mm。CTA能清晰显示动脉瘤夹闭术后情况。结论:16层螺旋CTA能及时准确诊断颅内动脉瘤,能够为临床提供重要信息,可作为动脉瘤夹闭术后病例随访的首要检查方法。

Objective：To evaluate the application of 16-slice spiral CT angiography in the diagnosis and evaluation of post-operative intracranial aneurysms treated by titanium clips.Methods： The study reviewed 38 patients with intracranial aneurysms confirmed by operation and DSA.All cases were evaluated by CTA,VR and MIP post-processing techniques to evaluate the size,shape,location,and relationship between the aneurysms and surrounding structures of intracranial aneurysms.The display of postoperative intracranial aneurysms treated by titanium clips was surveyed.Results： Forty-two intracranial aneurysms were detected in 38 patients.Two were seen in two cases.Three were seen in one case.Twenty aneurysms were located at posterior communicating artery,10 at the anterior communicating artery,six at middle the cerebral artery,five at the carotid artery,and one at the vertebral artery.Twenty-eight were saccular aneurysms,eight fusiform aneurysms,and six irregular aneurysms.The diameters were between 2.0 mm and 23.0 mm,average diameter was 5.8 mm.The CTA gave a clear display of postoperative intracranial aneurysms treated by titanium clips.Conclusion： A 16-slice spiral CT angiography can accurately diagnose intracranial aneurysms and provide more valuable information for clinical therapy.A CTA can be used as a first postoperative follow-up examination for aneurysms treated by titanium clips.