螺旋CT血管造影在脑动脉瘤诊断及治疗中的应用兼与MR血管造影比较

Application of spiral CT angiography in the diagnosis and therapy of cerebral aneurysms:com-pared with MR angiography

目的探讨无创性的螺旋CT血管造影(SCTA)与MR血管造影(MRA)对脑动脉瘤的诊断价值以及对治疗的指导价值,并对两者作比较。方法28例病人同时行SCTA、MRA、DSA,以DSA作为金标准,对SCTA与MRA作比较。结果①23例行SCTA及时间飞跃法(TOF)MRA者,SCTA诊断脑动脉瘤的准确性高于TOFMRA(P<0.05)。②SCTA较TOFMRA测量脑动脉瘤的最大径准确性高(P<0.01),TOFMRA测量值常偏小。③SCTA测量的栓塞治疗最佳投照角度与DSA符合率94.7%。④动态增强(DCE)MRA的图像清晰度及价值与SCTA相似。结论SCTA对体积小、破裂出血的脑动脉瘤的诊断准确性以及对动脉瘤测量的精确性高于TOFMRA,SCTA可较准确地测量动脉瘤栓塞治疗的最佳投照角度,DECMRA是脑动脉瘤电解可脱弹簧圈栓塞术后随访的较好方法,DCEMRA的实用价值与SCTA相似。

Objective To assess the diagnotic value of cerebral aneurysms and the directive value of therapy of spiral CT angiography(SCTA)and MR angiography(MRA).The differences of these two noninvasive imgaging modalities were studied at the same time.Method28cases of cerebral aneurysms underwent SCTA?MRA and DSA simultaneously.SCTA and MRA were compared using DSA as gold standard.Results①The diagnotic accuracy of SCTA was higher than that of time -of-flight (TOF)MRA(P<0.05)in23cases of cerebral aneurysm which underwent both these two examinations.②The accuracy of SCTA to measure the diameter of cerebral aneurysm was higher than that of TOF MRA(P<0.01).TOF MRA often got smaller measurement than DSA.③The optimal projection angles used in the endovascular embolization chosen by SCTA were identical with DSA in94.7%cases.④The image quality and value of dynamic contrast-enhanced(DCE)MRA was similar to SCTA.Conclu sion Theaccuracy of SCTA to diagnose the small,ruptured cerebral aneurysms and measure the aneurysms' diameter was higher than that of TOF MRA.SCTA can measure the optimal projection angles for endovascular embolization accurately.MRA is a good method to follow-up the aneurysms treated with Guglielmi detachable coils.The value of DCE MRA is similar to SCTA.