多层螺旋CT血管成像在颅内多发动脉瘤诊断中的应用价值

Applications of MSCTA in Diagnosis of Multiple Cerebral Aneurysms

目的探讨多层螺旋CT血管成像(MSCTA)在颅内多发动脉瘤诊断中的应用价值。方法选取2010年1月—2013年6月于本院诊治的10例颅内多发动脉瘤患者,均经数字减影血管造影(DSA)或手术证实。10例患者均进行MSCTA检查,并采用最大密度投影(MIP)、多平面重组(MPR)、曲面重组(CPR)、容积再现(VR)等三维重组脑动脉,观察动脉瘤的数目、瘤体大小、瘤颈宽度、载瘤动脉及瘤体与周围结构的关系等。结果 10例患者经DSA或手术确诊了23枚颅内多发动脉瘤,其中MSCTA显示了22枚(95.7%)脑动脉瘤的部位、形态、大小、瘤顶指向、瘤颈宽度、载瘤动脉及其与相邻结构的关系,并且与DSA或手术所见结果高度符合,仅1枚小动脉瘤因入口过窄、腔内有部分血栓导致MSCTA未显影。结论 MSCTA可作为颅内多发动脉瘤诊断、治疗方案选择、术后随访的首选影像学无创检查手段。

Objective To investigate the diagnostic value of multidetector- row spiral computed tomographic angiography（MSCTA） on multiple cerebral aneurysms.Methods A total of 10 patients who were diagnosed with multiple cerebral aneurysms by digital subtraction angiography（DSA） or surgery and treated in our hospital from January 2010 to June 2013,were selected as study subjects.All patients were examined by MSCTA and 3D cerebral artery images were reconstructed by volume rending（VR）,maximum intensity projection（MIP）,multiple planar reformation（MPR） and curved planar reformation（CPR） methods.The number and size of cerebral aneurysm,width of aneurysm neck,the relationship between parental artery,aneurysm and surrounding structure were analyzed.Results There were 23 intracranial aneurysms in 10 patients.All the multiple cerebral aneurysms verified by DSA and surgery.In these patients,22（95.7%） aneurysms were detected by MSCTA,but 1 aneurysm with small aneurysm neck and intracavity thrombus was missed.After reconstructing,MSCTA revealed the position,shape,size,the axis direction of the aneurysm apex and the width of aneurysm neck,the relationship between parental artery and the surrounding structures.The diagnosis of MSCTA was in accordance with results of DSA and surgery.Conclusion MSCTA is the effective,non- invasive imageology methods for diagnosing multiple cerebral aneurysms,selecting therapeutic schedule and follow- up after surgery.