颅内囊性动脉瘤三维影像学特征及临床意义  

imaging characteristics of intracranial berry aneurysms and its clinical significance

作　　者：赵兵[1] 钟鸣[1] 谭显西[1] 孙厚长[2] 郑匡[1] 张明升[1] 陈伟建[2] 

机构地区：[1]温州医学院附属第一医院神经外科,325000 [2]温州医学院附属第一医院影像科,325000

出　　处：《中国医师进修杂志（外科版）》2009年第6期5-8,共4页Chinese Journal of Postgraduates of Medicine

基　　金：浙江省卫生厅资助项目（2008A117）

摘　　要：目的观察颅内囊性动脉瘤的三维立体形态及颅底血管变异情况。方法回顾性分析2007年1—12月收治的颅内囊性动脉瘤70例患者的临床资料。动脉瘤数83个，通过多层螺旋CT血管造影影像工作系统观察动脉瘤的位置、大小、形态、瘤颈方向及颅底血管变异情况。结果颅内囊性动脉瘤位于前交通动脉43．37％（36／83），后交通动脉28．92％（24／83），颈内动脉9．64％（8／83），大脑中动脉6．02％（5／83），大脑前动脉A1-A33．61％（3／83），基底动脉3．61％（3／83），大脑后动脉2．41％（2／83），小脑下后动脉1．20％（1／83），脉络膜前动脉1．20％（1／83），形态以规则形态为主。颅底血管变异发生率为56．63％（47／83），前交通动脉瘤中大脑前动脉A1发育不良或缺如的变异发生率为72．22％（26／36）。结论颅内囊性动脉瘤的立体形态及血管变异均可通过多层螺旋CT血管造影充分显示，动脉瘤的发生可能与颅底动脉变异相关。Objective To review the three-dimensional characteristics and configuration of cranial base arteries of patients with intracranial berry aneurysms. Methods All the 70 patients with intracranial berry aneurysms （83 cases）were admitted from January to December in 2007. Their images of spiral computer angiography （CT） were presented and analyzed retrospectively. The site, size and figures of aneurysms were recorded, especially the variations of cranial base arteries were analyzed. Results Cerebral anterior communicating artery （ACoA） was the frequent site where aneurysms located. Incidence of ACoA aneurysms was 43.37%（36/83 ）, that of posterior communicating artery （PCoA） was 28.92%（24/83 ）, that of internal carotid artery was 9.64% （ 8/83 ） ,that of middle cerebral artery was 6.02% （5/83）, that of A1-A3 was 3.61% （3/83）,that of basilar artery was 3.61% （3/83）,that of posterior cerebral artery was 2.41% （2/83）, that of posterior inferior eerebellar artery was 1.20% （1/83）,that of anterior choroidal artery was 1.20% （1/83）.The shape of many berry aneurysms was regular. Mutational rate of cranial base arteries among aneurysms were 56.63% （47/83） and ACoA aneurysms with A1 dysplasia rate was 72.22% （26/36）. Conclusions The solid shape and vascular variation of intracranial berry aneurysms can be optimally identified by spiral computer angiography. The occurrence of berry aneurysms might be associated with variation of cranial base arteries.

关 键 词：颅内动脉瘤 成像 三维 血管变异 

分 类 号：R739.410.5[医药卫生—肿瘤] R739.41[医药卫生—临床医学]