双源CT血管成像诊断颅内动脉瘤的价值并与DSA比较

Value of dual-source CT angiography in diagnosis of intracranial aneurysm and compare with DSA

目的探讨双源CT血管成像(DSCTA)多种后处理技术对颅内动脉瘤的诊断价值。方法回顾性分析经手术或数字减影血管造影术(DSA)证实的颅内动脉瘤38例。采用西门子双源CT机(Somatom Definition),所得原始数据在工作站采用容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)、曲面重组(CPR)、去骨减影及双能去骨减影技术对动脉瘤的大小、瘤颈、瘤内血栓、瘤壁钙化及载瘤动脉等方面进行显示。结果 DSCTA显示颅内动脉瘤38例,单发33例,4例为2个动脉瘤,1例为3个动脉瘤,共44个动脉瘤。颈内动脉17个,前交通动脉8个,基底动脉6个,后交通动脉5个,大脑中动脉4个,大脑前动脉4个。动脉瘤平均直径(7.2±1.7)mm,最小动脉瘤直径2.1 mm。清晰显示瘤颈38例,44个动脉瘤瘤壁钙化4例,瘤内血栓3例。结论 DSCTA多模式重建技术可清楚显示颅内动脉瘤的大小、形态、位置、多少及其与周围结构的关系,是颅内动脉瘤的检出及制定治疗计划的非常有用的方法。

Objective To evaluate the clinical value of dual-source CT angiography （DSCTA） with multiple mode reconstructions in the diagnosis of intracranial aneurysm. Methods Thirty-eight patients with 44 intracranial aneurysms confirmed by digital sub- traction angiography （DSA） or surgery underwent DSCTA examination. The DSCTA data of these 38 patients were processed with volume rendering （ VR ） , maximum intensity projection （ MIP ） , multiplanar reformation （ MPR ） , curved planar reformation （CPR）. Results Of the 38 patients, 33 suffered from single aneurysm, 4 from dual aneurysms and 1 from triple aneurysms. All the 44 cerebral aneurysms were detected by DSCTA, with aneurysms located at internal carotid artery （ n = 17 ） , anterior communi- cating artery （ n = 8 ） , basilar artery （ n = 6 ） , posterior communicating artery （ n = 5 ） , middle cerebral artery （ n = 4 ） , anterior cerebral artery （ n = 4）. The average diameter of aneurysms was （7.2 ~ 1.7） mm, and the least size was 2.1 mm. The aneurysm neck was clearly displayed in 38 cases, aneurysms in 44 cases, aneurysm wall calcification in 4 cases, and aneurysm thrombus in 3 cases. Conehlsion DSCTA with multiple mode reconstructions can display clearly the location, size and shape of intracranial an- eurysm as well as their relationship with the adjacent anatomic structures. This is very useful for both detection and therapy planning of intraeranial aneurysms.