多层螺旋CT血管造影在颅内动脉瘤的诊断及术后随访中的临床价值研究

Multislice spiral CT angiography study in the diagnosis of intracranial aneurysms

目的:探讨多层螺旋CT血管造影(MSCTA)在诊断头颅动脉瘤及术后随访中的临床价值。方法:回顾性分析121例临床高度怀疑动脉瘤患者的头颅MSCTA及DSA影像资料,确诊后经外科手术或介入栓塞治疗后复查MSCTA及DSA,确诊病例均经手术或介入治疗证实。结果:121例患者中动脉瘤患者116例(动脉瘤124个),其中3例患有多发动脉瘤,分别有3、4、4个动脉瘤,MSCTA诊断125个动脉瘤,4个误诊,正确诊断121个,MSCTA检出率为97.6%;DSA诊断123个动脉瘤,误诊3个,漏诊4个,而且MSCTA所发现的动脉瘤中DSA检出率为96.7%,两种方法在检出率上比较,差异无统计学意义(P>0.05)。结论:MSCTA检查具有微创、快速、准确的优点,并发症极少,拥有强大的后处理功能,可清晰显示动脉瘤的所在部位、数目、大小、范围及其与周围结构组织之间关系,可以较为正确的诊断及评估术后所放弹簧栓的位置、形态,能观察动脉瘤是否完全闭塞、载瘤动脉的通畅情况以及动脉瘤颈是否完全栓塞,可作为诊断颅内动脉瘤及术后随访的首选检查方法,具有极高的临床应用价值。

Objective： To study the clinical application value of multislice spiral CT angiography（MSCTA） in the diagnosis of intracranial aneurysms. Methods： The MSCTA and DSA imaging data of 121 cases highly suspected of intracranial a- neurysm were analysed retrospectively. All cases were eomfirmed by surgical operation or interventional embolization. After treatment all eases were given MSCTA and DSA re-examinations. Result： In the 121 patients, 116 patients had intracranial a- neurysm（ahogether 124 aneurysms）, while in 3 cases there were 3, 4 and 4 aneurysms respectively. MSCTA gave correct diag- nosis in 121 aneurysms and misdiagnosed in 4 with a detection rate of 97.6%, DSA detected I23 aneurysms, misdiagnosed in 3 and 4 miss diagnosed. The detection rate of DSA was 96.7%. There was no significant difference of detection rate between the two examinations（P〉0.05）. Conclusion： MSCTA has minimal invasion, fast, accurate, with very few complications, and pow- erful post-processing capabilities. It is a method of choice for the diagnosis of intraeranial aneurysms.