3D-CTA在颅内动脉瘤诊治中的应用  

The clinical value of 3D-CTA in diagnosis and treatment of intracranial aneurysms

作　　者：石鑫[1] 鲍遇海[1] 买买提力[1] 赛力克[1] 成晓江[1] 

机构地区：[1]新疆医科大学第一附属医院神经外科,新疆乌鲁木齐830054

出　　处：《中国微侵袭神经外科杂志》2004年第8期343-346,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨3D-CTA在颅内动脉瘤诊断和治疗中的应用价值。方法采用3D-CTA检查疑似颅内动脉瘤病人52例,根据造影结果决定直接手术或进一步行3D-DSA检查。术后均复查3D-CTA。结果共发现58个动脉瘤,6例查3D-CTA及3D-DSA均未发现动脉瘤。3D-CTA对颅内动脉瘤诊断的敏感度、特异度、阴性似然比分别是94.8%、100%、0.052。诊断颅内动脉瘤病人的敏感度、特异度、阴性似然比分别是97.8%、100%、0.022。术前3D-CTA在估计动脉瘤大小及形态方面与术中所见+3D-CTA结果相似。3D-CTA清晰显示了动脉瘤的自身形态和周边的关系。结论3D-CTA是诊治颅内动脉瘤的一种快捷、安全、操作简便的方法,为制定手术方案提供了详细的资料,具有很高的临床实用价值。Objective To evaluate the clinical value of three-dimensional computerized tomography angiography (3D-CTA) in the diagnosis and treatment of intracranial aneurysms. Methods 52 patients with suspected intracranial aneurysms were examined by 3D-CTA systems. The decision of whether direct surgery or further 3D-DSA examinations was made on the basis of the type and quality of information provided by 3D-CTA. All cases underwent postoperative 3D-DSA. Results 58 intracranial aneurysms were identified in 52 patients. In 6 patients, both 3D-CTA and 3D-DSA were negative for a source of subarachnoid hemorrhage (SAH). The sensitivity, specificity, and negative likelihood ratio of 3D-CTA in the detection of intracranial aneurysms were 94.8%, 100% and 0.0518 respectively, and on a per-aneurysm basis respectively were 97.8%,100% and 0.022. There was an excellent correlation between 3D-CTA, 3D-DSA and surgery in assessing the size and shape of aneurysm. The morphological characteristics and surrounding of the aneurysm was displayed clearly in 3D-CTA. Conclusion 3D-CTA is a quick, reliable and relatively noninvasive method for diagnosing intracranial aneurysms. It delineates detailed aneurismal morphology, and provides useful information in planning microsurgical approaches.

关 键 词：颅内动脉瘤 CT血管造影 手术夹闭 数字减影全脑血管造影 

分 类 号：R739.4[医药卫生—肿瘤]