3D-CTA在诊断脑血管性疾病中的应用

Clinical value of diagnosis of cerebral vascular diseases with 3D-CTA

目的探讨CT血管造影(CTA)在诊治脑血管病中的应用价值。方法对54例脑血管病行CTA检查,采用最大强度投影(MIP)和容积成像显示(VR)技术进行三维重建;分析脑血管显示情况并将结果与DSA和(或)手术结果比较。结果 CTA最终诊断脑动脉瘤24例,脑动脉畸形9例,大脑中动脉梗死11例,脑室先天变异3例,3例为烟雾病。1例DSA诊断的小动脉瘤CTA检查未发现颅内异常,有3例两项检查均未发现异常,以DSA为金标准,计算16层螺旋CTA对脑血管病患者的诊断价值,CTA检测脑血管病的灵敏度为97.9%(48/49),特异度为75.0%(3/4),准确性为98.1%(53/54)。结论 CTA是有效的血管成像技术,对脑血管疾病有重要的诊治价值,可作为脑血管病患者DSA诊疗前重要的筛查技术。

[Objective ] To study the CT angiography （CTA） in the diagnosis and treatment of cerebrovascular dis- eases. [ Methods ] 54 patients with cerebral vascular diseases of DSA were examined with CTA. The results were analyzed with maximum intensity projection （MIP） and volume rendering display （VR） reconstruction technique and compared with DSA and （or） operation. [ Results ] In 54 patients with cerebral vascular diseases, cerebral aneurysm 24 cases, cerebral arteries deformity 9 cases, middle cerebral artery infarction 11 cases, ventricle congenital anoma- lies 3 cases, moyamoya disease 3 cases,4 cases were not found intracranial abnormalities. Compared with conven- tional DSA, the sensitivity, specificity and accuracy of CTA with regard to detection of cerebrovascular diseases in all 54 patients were 97.9% （48/49）, 75.0% （3/4）, 92.3% （48/52） respectively. [Conclusions] CTA , a vascular imag- ing technology, can be used as a screening technique in patients with cerebral vascular disease before DSA.