三维CT血管成像诊断颅内动脉瘤的临床价值研究  

Study of the 3D-CTA in the diagnosis of intracranial aneurysms

作　　者：饶以华[1] 方加胜[1] 张明宇[1] 霍雷[1] 

机构地区：[1]中南大学湘雅医院神经外科,湖南长沙410008

出　　处：《中国现代医学杂志》2010年第9期1345-1347,1350,共4页China Journal of Modern Medicine

摘　　要：目的探讨三维CT血管成像(3D-CTA)技术诊断颅内动脉瘤的临床价值。方法对临床考虑颅内动脉瘤的66例患者同期行3D-CTA检查和三维数字减影血管造影(3D-DSA)检查,3D-CTA检查包括多层平面重建(MPR)、最大密度投影(MIP)、表面遮盖显示(SSD)、容积再现(VR)和仿真内窥镜技术(VE),对确诊为颅内动脉瘤的患者行显微外科手术或介入治疗。结果①3D-DSA确诊57例患者有颅内动脉瘤共62个,3D-CTA检出58个动脉瘤,漏检4个,诊断正确率为93.5%。②原始图像、MPR、SSD、MIP及VR检出脑动脉瘤的灵敏度分别为46.8%、58.1%、62.9%、74.2%及88.7%,以VR技术最优,其次是MIP技术。③SSD、MIP及VR3种成像技术对小动脉瘤的检出率分别为41.3%、65.6%及84.8%,差异有统计学意义(χ2=12.962,P<0.05)。④3D-CTA对动脉瘤的瘤体、瘤颈及周围结构关系显示良好,还可显示附壁血栓及钙化。结论 3D-CTA结合MIP、VE及VR等后处理技术是临床诊断颅内动脉瘤的有效手段,具有无创、快速、价廉、准确率高及重复性好等特点,值得临床推广。【Objective】To research the clinical value of five imaging techniques of 3D-CTA,including multiplanar reformation（MPR）,maximum intensity projection（MIP）,shaded surface display（SSD）,volume rendering（VR） and vitual endoscopy（VE） in the diagnosis of intracranial aneurysms.【Methods】66 cases who were suspected to suffer from intracranial aneurysms were scanned by 3D-CTA and three-dimension digital subtraction angiography（3DDSA）.【Results】Results of operation and 3D-DSA showed that 57 patients were identified with 62 intracranial aneurysms.The other 9 patients were not detected any aneurysms.54 patients were identified with 58 aneurysms by 3D-CTA,and 4 aneurysms in 3 patients were leaked out by 3D-CTA;VR was found superior to SSD and MIP in the detection of small intracranial aneurysms.The detection rate had significantly difference among the three methods（χ2= 12.962,P 0.05）;The sensitivity of detecting aneurysms in original image,MPR,SSD,MIP and VR was 46.8%,58.1%,62.9%,74.2%,and 88.7% respectively.Application of MIP could display the morphological characteristics of aneurysm and it＇s relationship with adjacent tissue clearly.【Conclusion】3D-CTA techniques such as VR,MIP and VE have their own predominant role and could complement each other.

关 键 词：颅内动脉瘤 三维CT血管成像 数字减影血管造影 

分 类 号：R739.41[医药卫生—肿瘤]