颅内小动脉瘤的CT征象及MSCTA在夹闭手术前后及随访中应用  

CT signs of small intracranial aneurysm and application of MSCTA before and after clipping surgery and in follow-up

作　　者：陈萍[1] 周和平[1] 朱亚男[1] 冉纯洁[1] 姚俊[1] 李辉[1] 李少杰[1] 张晓丽[1] 

机构地区：[1]安康市中心医院CT室,陕西安康725000

出　　处：《医疗卫生装备》2017年第3期86-89,共4页Chinese Medical Equipment Journal

摘　　要：目的:探讨颅内小动脉瘤的CT征象及多层螺旋CT血管成像(multi-slice spiral CT angiography,MSCTA)在夹闭手术前后及随访中的应用价值。方法:回顾性分析2013年3月至2015年3月到医院就诊的81例高度怀疑颅内小动脉瘤患者的MSCTA影像学资料,确诊患者均行颅内动脉瘤夹闭术,分析夹闭手术前后影像学表现,并与数字减影血管造影(digital subtraction angiography,DSA)及术中所见对比。结果:MSCTA相对于DSA及术中所见诊断颅内小动脉瘤的准确率、敏感性、特异性分别为93.83%、93.75%、94.12%;MSCTA相对于DSA及术中所见诊断颅内小动脉瘤结果一致性好(Kappa=0.825)。MSCTA诊断颅内小动脉瘤大小的准确性与DSA及术中所见无差异。MSCT平扫显示以蛛网膜下腔或颅内出血为主。MSCTA术前诊断显示60例患者共71个颅内动脉瘤,形态为菱形、囊形;64例患者行颅动脉夹闭术,术后2周复查MSCTA,60例患者满意;36例患者术后随访6~12个月无异常。结论:MSCTA能为颅内小动脉瘤夹闭术提供丰富信息,还可作为术后评估和随访的首选影像学方法。Objective To investigate the CT signs of small intracranial aneurysm and the application value of multi-slice spiral CT angiography（MSCTA）before and after clipping surgery and in follow-up.Methods MSCTA imaging data of 81patients with highly suspected small intracranial aneurysms from March 2013 to March 2015 were analyzed retrospectively.The confirmed patients underwent clipping surgery of small intracranial aneurysms.The imaging findings before and after clipping surgery were analyzed and compared with those by DSA and what observed during surgery.Results The relative accuracy,sensitivity and specificity of MSCTA over DSA and surgical diagnosis were 93.83%,93.75%and 94.12%respectively,and MSCTA gained high relative consistency over DSA and surgical diagnosis（Kappa=0.825）.The accuracy of MSCTA for diagnosing small intracranial aneurysm was not significantly different from those by DSA and surgical diagnosis.MSCT plain scan mainly showed subarachnoid or intracranial hemorrhage,and found 71 rhomboic or saccular aneurysms in60 patients before operation.Totally 64 patients went through clipping surgery,60 ones had satisfactory results in the reexamination by MSCTA 2 weeks after surgery,and there were no abnormality found in 36 patients in 6 to 12-month follow-up.Conclusion MSCTA can provide abundant information for clipping surgery of small intracranial aneurysms,and can be used as the preferred imaging method for postoperative evaluation and follow-up.

关 键 词：颅内小动脉瘤 螺旋CT CT血管成像 动脉瘤夹闭 术后评估 

分 类 号：R743[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]