多层螺旋CT血管造影对于外科处理脑动脉瘤蛛网膜下腔出血的指导作用和临床经验

Multislice spiral CT angiography and clinical experience of surgical treatment for guidance of cerebral aneurysm subarachnoid hemorrhage

目的研究多层螺旋CT血管造影(MSCTA)诊断脑动脉瘤的临床应用。方法选择我院2014年10月~2017年1月收治的60例蛛网膜下腔出血疑似脑动脉瘤患者进行的MSCTA检查的临床资料,其中15例行保守治疗;其余45例行MSCTA患者经过外科处理,包括41例经DSA血管内处理,4例经开颅手术治疗。分析CTA的诊断准确性、应用价值和作者的使用经验。结果CTA:所有患者中45例MSCTA诊断脑动脉瘤共47个,DSA及开颅术发现脑动脉瘤49个,诊断符合率为95.9%;CTA与DSA对瘤体长轴、瘤体短轴与瘤颈进行分析显示,两种检测方法的检测数据均无明显差异,P>0.05。结论对于颅内动脉瘤患者采取MSCTA检测的临床意义重要,有利于显示出患者颅内动脉瘤的瘤体大小与瘤颈,诊断方法安全、可靠。

Objective Research and sum up of clinical application of MSCTA in diagnosis of cerebral aneurysms.Methods The clinical data of60patients with suspected subarachnoid hemorrhage who underwent MSCTA in our hospital from October2014to January2017were selected,Among them,15cases underwent conservative treatment,and the remaining45cases underwent MSCTA got surgical treatment,which including41cases underwent DSA endovascular treatment and4cases underwent craniotomy.The diagnostic accuracy,application value and the author's experience of CTA were analyzed.Results A total of47cerebral aneurysms were diagnosed by MSCTA in45patients,while49cerebral aneurysms were detected by DSA and craniotomy.The diagnostic coincidence rate was95.9%.There was no significant difference between CTA and DSA that used to analyze the long axis of the tumor,the short axis of the tumor,and the neck of the tumor,P>0.05.Conclusion For patients with intracranial aneurysms,the detection of MSCTA has important clinical significance.It is helpful,safe and reliable to show the tumor size and neck of the patient's intracranial aneurysm.