颈内动脉血泡样动脉瘤的CTA诊断  

CT angiography in the diagnosis of internal carotid artery blister-like aneuryms

作　　者：陈状[1] 李林[1] 崔静[2] 公方和[1] 王伟民[1] 

机构地区：[1]广州军区广州总医院神经外科,广州510515 [2]广州军区广州总医院放射科,广州510515

出　　处：《中华神经医学杂志》2012年第2期149-151,共3页Chinese Journal of Neuromedicine

摘　　要：目的分析颈内动脉血泡样动脉瘤（BBA）CT三维血管重建（cTA）的诊断价值及形态特征。方法回顾性分析广州军区广州总医院神经外科自2008年1月至2009年12月收治的143例自发性蛛网膜下腔出血（SAl4）患者资料。所有患者均先后行CTA及DSA检查，并对结果进行对比分析。结果所有患者经平扫CT诊断为自发性SAH，其中6例经DSA确诊为颈内动脉BBA。该6例患者中4例在DSA检查之前即经CTA确诊，未经CTA确诊的2例患者中1例后虽经DSA检查明确，但回顾分析CTA仍未发现明确病变。全部6例患者均经血管内支架治疗，术后均单纯经DSA随访，平均随访时间8-3个月（6-18个月）。4例患者复发并再手术。结论当自发性SAH经CTA检查未发现明确原因时，有必要进行详细的DSA检查，以除外是否存在颈内动脉BBA．Objective To explore the utility ofCT angiography （CTA） in the identification and characterization of internal carotid artery （ICA） blood blister-like aneuryms （BBA）. Methods All the 143 patients with spontaneous subarachnoid hemorrhage （SAH） who had been managed in our department from January 2008 to December 2009 were analyzed retrospectively. All of them underwent CTA prior to digital subtraction angiography （DSA） for evaluation of spontaneous SAH. The reports from the CTA and DSA were reviewed to determine whether the ICA BBA had been correctly and prospectively diagnosed. A retrospective review of the CTA and DSA images was also performed. Results All patients were diagnosed with spontaneous SAH by plain scan CT. We identified 6 cases of ICA BBA on initial DSA imaging. Of the 6 blister-like aneurysms, 4 （67%） were identified prospectively and 5 （86%） retrospectively on CTA. In one case that had been confirmed by DSA as ICA BBA, the retrospective CTA failed to find the abnormity. All the 6 patients underwent endovascular treatment with stent placement. All patients were followed up for an average of 8.3 months （range, 6-18 months） simply by DSA after treatment. Conclusion If CTA identifies a spontaneous SAH but fails to identify the cause, a careful DSA should be performed to detect a possible presence oflCA BBA.

关 键 词：血泡样动脉瘤 颈内动脉 CT血管重建 数字减影全脑血管造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学]