双源 CT 血管造影对颅内动脉瘤的术前评估  

Preoperative assessment of intracranial aneurysms through dual -source CT angiography

作　　者：朱丽丽[1] 蔡廷江[2] 史跃[1] 赵汉青[1] 陈凯[1] 李皖陇[1] 刘忱[1] 周德兴[1] 孙晨曦[1] 

机构地区：[1]中国人民解放军第九七医院影像科,江苏徐州221004 [2]中国人民解放军第九七医院神经外科

出　　处：《徐州医学院学报》2015年第3期197-200,共4页Acta Academiae Medicinae Xuzhou

基　　金：南京军区医学科学研究“十一五”计划课题（2006MA46）

摘　　要：目的：探讨双源 CT 血管造影（CTA）在颅内动脉瘤术前评估中的应用价值。方法回顾性分析43例疑诊颅内动脉瘤的蛛网膜下腔出血患者的双源 CT 血管造影图像，并与数字减影血管造影（DSA）或手术所见对照。结果43例中 CTA 检出37例39个动脉瘤，6例阴性。 CTA 清晰显示动脉瘤的部位、大小、形态、指向、瘤颈、瘤壁钙化、瘤内血栓、载瘤血管及与周围组织的关系等病变细节。25例（CTA 阳性19例和阴性 6例）行 DSA 检查，检出20例20个动脉瘤，5例阴性。共21例颅内动脉瘤患者接受外科手术治疗。除漏诊 1例 ＜3 mm 的动脉瘤外，CTA 所示动脉瘤细节与 DSA 或术中所见完全一致。结论双源 CT 血管造影能快速诊断颅内动脉瘤并提供动脉瘤及颅内情况的详实信息，为术前评估提供重要指导性依据。Objective To assess the application of dual -source CT angiography （CTA） for preoperative assessment of intracranial aneurysm.Methods Images were collected from 43 subarachnoid hemorrhage patients with suspected intracranial aneurysm who underwent dual -source CTA.These data were retrospectively analyzed and then compared with those obtained through digital subtraction angiography （DSA） and surgical findings.Results Using CAT, 39 out of 43 patients with suspected aneurysm were diagnosed, with 6 negative cases.CTA could clearly display the pathological changes of aneurysm in details such as location, size, shape, pointing, aneurysmal neck, calcification of the aneurysmal wall, intra -aneurysmal thrombosis, aneurysm -bearing vessels and their relationship with surrounding tissues.There were also 25 patients （including 19 CAT positive and 6 negative patients） who underwent DSA, in which 20 CAT positive （with 20 aneurysms） and 5 negative patients were determined.Furthermore, a total of 21 aneurysm patients were treated by surgery.The pathological details of aneurysms which were reflected through CTA were consistent with those obtained through DSA or surgical findings, except one case where an aneurysm less than 3 mm was missed diagnosed.Conclusion CTA can be applied for quick diagnosis of intracranial aneurysm, while showing detailed information about aneurysm and its surroundings, which then provides important evidence for preoperative assessment.

关 键 词：颅内动脉瘤 双源CT 血管造影 数字减影血管造影 

分 类 号：R814.43[医药卫生—影像医学与核医学]