3D-CTA在颅内动脉瘤诊断与治疗中的应用

Application of Three Dimensional CT Angiography in the Diagnosis and Managements of Intracranial Aneurysms

目的探讨三维CT血管造影(3DCTA)在颅内动脉瘤病因诊断和治疗中的临床价值。方法对2010年9月至2013年10月就诊的75例自发性蛛网膜下腔出血患者先行头颅3D-CTA检查,3D-CTA诊断为动脉瘤的患者行动脉瘤夹闭术或介入栓塞术,3D-CTA诊断阴性的患者进一步行DSA检查。结果 75例患者中3D-CTA检出63例动脉瘤,后经介入栓塞或手术证实63例动脉瘤患者中61例为动脉瘤,2例为血管扭曲。12例3D-CTA检查阴性,后经DSA检查后1例确诊为动脉瘤。3DCTA对颅内动脉瘤病因诊断的敏感性为96.8%,特异性为91.7%。结论对于急性蛛网膜下腔出血怀疑颅内动脉瘤的患者,3D-CTA诊断准确率高,且可提供许多有用的治疗信息,在基层医院是首选的诊断方法。

Objective To explore the clinical value of three dimensional computed tomography angiography（3D-CTA）in the etiological diagnosis and management of intracranial aneurysm. Methods 75 cases of spontaneous subarachnoid hemorrhage patients from September 2010 to October 2013 performed 3D-CTA examination, patients who were diagnosed as aneurysms underwent surgery or interventional embolization, 3D-CTA-negative patients received DSA examination. Results 3D-CTA detected 63 cases of aneurysms in all cases. After embolization or surgery confirmed 61 cases of aneurysms, 2 cases of vascular distortion. 12 cases of 3D-CTA examination was negative, one of them was diagnosed as aneurysms by DSA. The sensitivity of 3D-CTA for the diagnosis of intracranial aneurysms was 96.8% and the specificity was 91.7%. Conclusion For patients with acute subarachnoid hemorrhage suspected intracranial aneurysms,diagnostic accuracy of 3D-CTA is high, and 3D-CTA can provide a lot of useful information for treatments, 3D-CTA is the preferred method for diagnosis of anurysm in prmary hospital.