摘要
目的探讨64排容积CT血管造影(CTA)及3D重建在急性颅内动脉瘤破裂出血诊疗中的临床应用价值。方法回顾性分析143例颅内动脉瘤破裂出血患者行急诊颅脑CTA检查,并经手术治疗的影像及临床资料,对照破裂动脉瘤的3D-CTA影像表现与外科手术及介入手术所见,评价其临床应用价值。结果 143例患者中,142例手术证实为破裂动脉瘤,1例为假性动脉瘤。急诊显微外科手术成功夹闭125个破裂动脉瘤,17例行DSA介入栓塞治疗;动脉瘤分布情况:颈内动脉-后交通段动脉瘤60个,占40.54%,前交通动脉瘤及大脑前动脉瘤43个,占29.05%,大脑中动脉瘤37个,占25%,椎-基底动脉瘤8个,占5.41%。142例颅内破裂动脉瘤影像所见大小、形态及位置与手术所见基本一致。结论 64排容积CT血管造影及3D重建在急诊颅内动脉瘤破裂出血诊断中具有准确、简便、快速及无创的优点,CTA-VR、MPR显示瘤体及载瘤动脉的三维立体图像,对临床确定手术入路及手术方式具有重要的参考价值。
Objective To evaluate the clinical application value of 64-slice volume CT angiography （CTA） and 3D reconstruction in diagnosis of acute ruptured intracranial aneurysm. Method Retrospective analysis the imagings and clinical informations of 143 patients with ruptured intracranial aneurysms,all patients had emergent craniocerebral CTA examination and surgical treatment, Contrast ruptured aneurysm 3D-CTA imaging findings with surgical and interventional surgical findings, evaluate its clinical application. Results 143 cases of patients, 142 cases were confirmed by surgery for the ruptured aneurysm, 1 case was pseudoaneurysm. Emergency micrographic surgery successfully clipped 125 ruptured aneurysms, 17 cases DSA embolization;Aneurysm distribution： internal carotid - posterior communicating artery aneurysm （60）, accounting for 40.54%, anterior communicating artery aneurysm and anterior cerebral artery aneurysms （43）, accounting for 29.05%, middle cerebral artery aneurysms （37）, 25%, vertebral - basilar artery （8）, accounting for 5.41%.142 cases of ruptured intracranialaneurysms seen in the image size, shape and location basically consistent with the operative findings. Conclusion 64-slice volume CT angiography and 3D reconstruction in the emergency diagnosis of intracranial aneurysm rupture has accurate, simple, rapid and non-invasive advantages,the 3D image of artery aneurysm and parent artery by CTA-VR and MPR display has important reference value for the clinician determine the surgical approach and surgical mode.
出处
《罕少疾病杂志》
2013年第5期36-39,共4页
Journal of Rare and Uncommon Diseases
