CT血管造影与3D-DSA对囊状未破裂脑动脉瘤的对比研究

CT Angiography with Intravenous Contrast Injection Compared with Conventional Rotational Angiography in the Diagnosis of Unruptuerd Cerebral Aneurysms

目的评估静脉注入造影剂的CTA与3D-DSA对于诊断颅内动脉瘤准确性的对比评价。方法 13例通过血管造影偶然发现的15个颅内囊性动脉瘤。对于每个患者,我们均进行静脉注射造影剂的CT血管造影和传统的血管造影包括三维旋转数字减影血管造影。在后处理过程中,应用多平面重建技术对于每个动脉瘤的最大直径、瘤颈直径、动脉瘤高度、最大宽度、凸起高度、载瘤动脉直径和载瘤动脉与动脉瘤顶端之间的夹角进行仔细测量。结果 3D-DSA和静脉注射造影剂的CT血管造影都能提供高质量的图像而没有运动伪像。所有参数的测量表明二者对颅内动脉瘤形态的诊断具有极高的相似性(P≤0.001)。结论 CTA是一种可行的、可视的、无创性的诊断囊状脑动脉瘤的手段并且通过评估动脉瘤的大小和几何形态可以提供与传统三维旋转数字减影血管造影术相媲美的可靠的诊断信息。此初步结果提示CTA可能成为脑动脉瘤介入治疗前取代DSA的一个有前途的诊断方法。

Objective Noninvasive imaging of cerebral aneurysms is still considered inferior to conventional angiography. The purpose of this study was to evaluate the diagnostic accuracy of ivACT in the assessment of intracranial aneurysms compared with 3D-DSA. Methods AND METHODS： We included 13 patients with 15 incidental unruptured saccular aneurysms scheduled for diagnostic angiographic in our study. In each patient,we performed anivACT and a conventional angiography including a 3D rotational run. During postprocessing,MPR images were generated for each technique. Maximal aneurysm diameter,neck diameter,aneurysm height,maximum width,bulge height,parent artery diameter,and angle between the parent artery and aneurysm apex were measured for each aneurysm. Results Both 3D-DSA and ivACT provided high quality images without artificial disturbances（ ie,motion artifacts）. Measurements of all parameters resulted in comparable values for both modalities with a strong correlation（ P≤0. 001）. Conclusions ivACT is feasible for the noninvasive visualization of saccular cerebral aneurysms and may provide reliable diagnostic information for the assessment of aneurysm size and geometry comparable with conventional intra-arterial 3D rotational angiography. These preliminary results might be a first promising step to replacing conventional angiography in preinterventional aneurysm imaging.