CT血管造影对颅内动脉瘤术后夹闭不全的评估价值

Estimated Values of CT Angiography for Incomplete Clipping after Intracranial Aneurysm Surgery

目的研究CT血管造影(CTA)对颅内动脉瘤术后夹闭不全的评估价值。方法收集我院2015年12月-2017年11月间收治的45例颅内动脉瘤行开颅夹闭动脉瘤术治疗的患者,术后均行CTA检查,分析CTA评估颅内动脉瘤术后闭夹不全的临床价值。结果所有患者均于术后7-15d进行CTA复诊,1例发现新生动脉瘤1枚,再次手术给予夹闭;2例出现夹闭不全,再次手术调整瘤夹位置;5例发现脑积水,行脑室腹腔分流术进行处理;阅片结果除1例图像质量显示不佳外,其余均可清晰显示载瘤动脉与动脉瘤夹间的关系、动脉夹数量与位置、载瘤动脉通畅与否、动脉瘤颈残留、脑血管痉挛等信息,术后3个月患者均回院复诊,均显示颅内情况良好。结论CTA检查具有无创、检查时间短、费用低等特点,可准确显示动脉瘤夹闭术后颅内血管、脑实质等情况,在颅内动脉瘤夹闭术后具有较高的应用价值。

Objective To study the estimated values of CT angiography（CTA） in incomplete clipping after intracerebral aneurysm surgery. Methods 45 cases of patients with intracranial aneurysms treated with neurosurgical clipping in our hospital from December2015 to November 2017 were collected and were given the CTA examination after operation. The clinical values of CTA in evaluating incomplete clipping after intracerebral aneurysm surgery were analyzed. Results All patients were given CTA return visit at7-15 d for after operation, and 1 case was found with 1 new aneurysm. There were 2 cases with incomplete clipping and reoperation was given to adjust the position of the tumor clip. 5 cases of hydrocephalus were found and treated with ventriculoperitoneal shunt.Except for 1 case with poor image quality of reading results, the rest could clearly show the relationship between the parent artery and aneurysm clips, the number and location of artery clip, whether the parent artery was smooth or not, aneurysm neck residual,cerebral vasospasm and other information. Patients were back to hospital for return visit at 3 months after operation, and all showed good intracranial condition. Conclusion CTA examination has the characteristics of non-invasive, short examination time and low cost.It can accurately display intracranial vascular and cerebral parenchyma after aneurysm clipping, and has high application values after clipping of intracranial aneurysms.