脑动脉瘤螺旋CT血管造影的评价

Application of spiral CT angiography in cerebral aneurysms

目的 :探讨螺旋CT血管造影在脑动脉瘤诊断和治疗中的价值。方法 :1 6例脑动脉瘤患者行SCTA和DSA检查 ,并进行对照研究 ,其中 8例行MRI检查。 4例行GDC栓塞治疗 ,2例巨大动脉瘤行球囊导管栓塞术 ,1例行外科手术 ,其余病例行内科保守治疗。结果 :所有 1 6例动脉瘤均在SCTA和DSA上清晰显示 ,瘤颈和瘤体大小 2种方法测量统计学差异无显著性意义 (P值均 >0 .0 5) ,对瘤壁钙化、瘤内情况如血栓、瘤颈情况、动脉瘤在颅内空间定位及动脉瘤与载瘤动脉的关系 ,SCTA较DSA具有优势 ,且对瘤体及瘤颈的测量SCTA较DSA方便、准确 ,SCTA操作简单、微创、无危险性 ,患者易于接受。结论 :SCTA对动脉瘤具有诊断作用 ,可作为脑动脉瘤诊断的筛查技术 ,对其治疗有重要的指导作用 。

Objective:To evaluate spiral CT angiography(SCTA) in diagnosis of cerebral aneurysms and follow up after treatment.Methods:A comparative study was made in 16 patients with cerebral aneurysms undergoing SCTA and digital substraction angiography(DSA) as well as additional MRI in 8.And 4 of them were performed implantation of Guglielmi detachable coil (GDC),2 embolization by detachable balloon,1 surgical operation,the remaining conservative treatment.Results:All aneurysms were clearly seen on SCTA and DSA.There was no statistic difference between the measurements about the size of aneurysms' neck and body on SCTA and DSA( P >0.05).However,in the demonstration of the wall calcification,intraluminal thrombus,neck and intracranial location of aneurysms,and the relationship between aneurysm and aneurysm carrying artery,SCTA was superior to DSA.SCTA is more simple and accurate than DSA in the measurement of the size of the neck and body of the aneurysm.And also it is safe,less invasive,and easy to be accepted by the patients.Conclusion:SCTA can be the method of first choice in screening and routine examination of intracrainial aneurysms before operation.