螺旋CT血管造影对脑动脉瘤栓塞治疗的指导价值

The Directive Value of Spiral CT Angiography in the Endovascular Embolization of Cerebral Aneurysms

目的 探讨螺旋CT血管造影 (SCTA)对脑动脉瘤电解可脱弹簧圈 (GDC)血管内栓塞治疗的指导价值。方法 脑动脉瘤患者 30例 ,行SCTA后一周内行DSA及GDC栓塞治疗。结果 ①SCTA检出了DSA发现的 35个脑动脉瘤中的 34个 ( 97.1% ) ,32个动脉瘤诊断正确 ( 91.4% )。② 32个选择GDC栓塞治疗的脑动脉瘤中 ,SCTA测量的最佳投照角度与DSA相同 30个 ( 93 .8% )。③MIP对动脉瘤瘤体及瘤颈测量值准确可靠 ,与DSA无显著差异 (P >0 .0 5 ) ;SSD法立体感优于MIP及DSA ,对瘤体测量值与DSA无显著差异 (P >0 .0 5 ) ,但对瘤颈测量值与DSA有显著差异 (P<0 .0 1) ,SSD常夸大瘤颈宽度。结论 SCTA不仅能较准确诊断脑动脉瘤 。

Purpose To evaluate the directive value of spiral CT angiography (SCTA) in the endovascular embolization of cerebral aneurysms with guglielmi detachable coil(GDC). Methods 30 patients with cerebral aneurysms underwent SCTA and within one week underwent DSA and endovascular treatment with GDC. Results ① 35 cerebral aneurysms were found by DSA in the 30 patients. SCTA detected 34 aneurysms (97.1%) and diagnosed 32 correctly (91.4%). ② The optimal projection angles chosen by SCTA were identical with DSA in 30 of 32 aneurysms which received GDC embolism (93.8%). ③ There were no obvious statistic differences between MIP and DSA about the bodies' length and the necks' width of the aneurysms ( P >0.05). It showed that the MIP technique was very accurate in the measurements of cerebral aneurysms. The SSD technique could provide more 3D informations than MIP and DSA. There was no obvious statistic difference between SSD and DSA about the bodies' length of aneurysms ( P >0.05), but there was obvious statistic difference about their necks' width ( P <0.01). The SSD technique overestimated the necks' width commonly. Conclusion SCTA can not only diagnose the cerebral aneurysms accurately but also provide the optimal projection angles and precious measurements for their endovassular treatment with GDC. [