颅内动脉瘤不同影像技术诊疗效果比较  

Comparative Study of 3D-DSA, 3D-CTA and MRA Techniques in the Diagnosis and Treatment of Intracranial Aneurysms

作　　者：毛崇梅 衣玲[2] 李胜[3] 

机构地区：[1]胜利油田胜东社区东辛卫生院,山东东营257055 [2]山东省眼科研究所,山东青岛266071 [3]山东省肿瘤防治研究院,山东济南250117

出　　处：《临床医学工程》2012年第9期1433-1436,共4页Clinical Medicine & Engineering

摘　　要：目的探讨CTA、MRA、DSA三维重建技术在诊断颅内动脉瘤的差异,为颅内动脉瘤患者的诊断及治疗方案的制订提供有价值的依据。方法选择急性蛛网膜下腔出血和/或疑似颅内动脉瘤的患者29例,行脑血管造影术(DSA)及三维重建(3D-DSA)。之前全部病例行3D-CTA、21例病例行MRA检查并行三维重建,以3D-DSA及脑外科术中检查为标准,比较3D-DSA与3D-CTA、MRA之间显示动脉瘤立体形态、载瘤动脉与毗邻血管的关系、瘤颈及其与载瘤血管关系及穿支情况等方面信息的区别。结果 SAH患者资料共29例,其中28例共患有动脉瘤38个,阴性1个。CTA和DSA/3D-DSA各检出27例37个动脉瘤,二者检出动脉瘤的数目及诊断符合率比较差异无统计学意义(P>0.05)。MRA检查18例动脉瘤,漏诊3例。结论 CTA/3D-CTA和DSA/3D-DSA二者检出动脉瘤的数目及诊断符合率比较差异无统计学意义,与MRA比较差异有统计学意义。DSA/3D-DSA在与载瘤动脉关系、动脉瘤上有无穿支方面优于CTA/3D-CTA及MRA。Objective To evaluate and compare the diagnostic and therapeutic value of 3D-CTA, 3D-DSA and MRA for intracranial aneurysms. Methods 29 patients suspected with intracranial aneurysms were examined by 64 slice spiral CTA and DSA respectively, and 21 had MRA inspection at the same time with 3D-DSA and intraoperative examination as the standard. The results were compared among the above three techniques. Results For 28 patients with 38 aneurysms （confirmed by 3D-DSA or intraoperative examination）, 37 aneurysms were detected by 3D-CTA and 3D-DSA, while only one aneurysm failed to develop. 18 aneurysms were detected by MRA, 3 aneurysms failed to develop. Conclusions 3D-DSA shows no significant difference to 3D-CTA in aneurysm display rate while they are significantly advantageous over MRA. But for the display of aneurismal shape, neck, and its relation to parent artery, 3D-CTA and 3D-DSA are significantly advantageous over MRA. 3D-DSA can more clearly demonstrate with the vascular of lesions and the relationship between the adjacent vascular, relations to parent artery, especially for vascular lesions.

关 键 词：蛛网膜下腔出血 3D—CTA 3D—DSA MRA 颅内动脉瘤 

分 类 号：R739.41[医药卫生—肿瘤] R814.43[医药卫生—临床医学]