螺旋CT血管造影诊断脑动脉瘤的价值

Study of the Value of Spiral CT Angiography in the Diagnosis of Cerebral Aneurysms

目的 :探讨螺旋CT血管造影 (SCTA)诊断脑动脉瘤的价值。材料和方法 :90例患者行SCTA ,层厚 1 0～ 2 0mm ,螺距 1 0 ,层间距 1 0mm ,均同时行SSD、MIP法重建 ;89例同时行DSA ,1例手术发现为脑动脉瘤 ,SCTA与DSA及手术对照。结果 :90例患者中阴性 2 6例 ,脑动脉瘤 64例 72个。SCTA诊断脑动脉瘤的敏感性、特异性、准确性分别为 94 4%、92 3 %、93 9% ;SCTA的SSD、MIP对 >5mm的脑动脉瘤检出率均很高 ,而MIP对≤ 5mm的小动脉瘤的检出率以及对动脉瘤颈的良好显示率明显高于SSD。结论 :SCTA对脑动脉瘤的诊断价值高 ,可补充DSA的诊断信息 ,可用于筛查脑动脉瘤及指导治疗。

Purpose: To evaluate the value of spiral CT angiography (SCTA) in the diagnosis of cerebral aneurysms. Materials and Methods: SCTA was performed in 90 patients suspected of having cerebral aneurysms. The slice thickness was 1.0～2.0mm, pitch 1.0, index1.0mm. Both SSD and MIP methods were used to reconstruct the images in every case. 89 patients underwent DSA at the same time and 1 patient found a cerebral aneurysm on operation. The results of SCTA were compared with DSA and neurosurgery. Results: 72 cerebral aneurysms were found in 64 patients and the remaining 26 cases revealed no abnormality. The sensitivity?specificity and accuracy of SCTA were 94.4%?92.3%?93.9% respectively. Both SSD and MIP technique of SCTA had high sensitivity to cerebral aneurysms over 5mm in size. The MIP technique detected more aneurysms smaller than or equal 5mm in size and clearly showed more aneurysms' neck than SSD. Conclusion: The diagnostic value of SCTA to cerebral aneurysms is high and SCTA can provide important supplementary information to DSA. SCTA is suitable for screening purposes and directing the treatment of cerebral aneurysms.