三维CT血管造影术在颅内动脉瘤夹闭术后的应用评价  

作　　者：罗谊[1] 鲍遇海[2] 买买提.艾力[2] 

机构地区：[1]新疆生产建设兵团医院神经外科 [2]新疆医科大学第一附属医院神经外科,新疆乌鲁木齐830002

出　　处：《中外医疗》2009年第27期153-154,156,共3页China & Foreign Medical Treatment

摘　　要：目的探讨3D-CTA与3D-DSA对比在应用于颅内动脉瘤开颅夹闭术后的评估价值。方法针对已行开颅动脉瘤瘤颈夹闭术的30例病人的30个破裂的动脉瘤进行研究。所有病人术后同期行3D-CTA及3D-DSA检查。由两组观察者分别对3D-CTA与3D-DSA影像进行评判,评判动脉瘤是否完全夹闭、载瘤动脉是否通畅。结果3D-CTA影像检查出6例动脉瘤瘤颈残余和1例血管影像异常,经3D-DSA影像证实。3D-CTA漏诊1例瘤颈残余。3D-CTA评价动脉瘤瘤颈残余的灵敏度85.6%,特异度100%;评价载瘤动脉和周围血管狭窄或闭塞的灵敏度100%,特异度96%。结论当使用纯钛动脉瘤夹时,3D-CTA可以替代3D-DSA常规应用于颅内动脉瘤开颅夹闭术后的评估。Objective To study the value of Three dimensional computerized tomography angiography （3D-CTA） technique compare with Three dimensional digital subtraction angiography （3D-DSA） in the postoperative evaluation of patients with clipped aneurysms. Methods 30 consective patients with 30 clipped aneurysms（30 of which had ruptured） were studied with the aid of postoperative 3D-CTA and 3D-DSA. Both types of radiological studies were reviewed independently by two observers to assess the quality of the image, the completeness of aneurysm occlusion,the patency of the parent vessel. Results Occlusion of the aneurysm on 3D-CTA was confirmed in all but six patients in whom a neck remnant was confirmed on 3D-DSA. The sensitivity and specificity for detecting neck remnants on 3D-CTA were 85.6% and 100%, respectively.the sensitivity, specificity and diagnostic accuracy for evaluating vessel patency were 100%.Conclusions 3D-CTA can replace 3D--DSA in using to the routine control examination of patients undergoing surgical clipping of intracranial aneurysms with titanium clips.

关 键 词：动脉瘤手术治疗 夹闭 瘤颈残余 闭塞或狭窄 三维CT血管造影术(3D-CTA) 三维数字减影血管造影术(3D-DSA) 

分 类 号：R651[医药卫生—外科学]