摘要
目的探讨三维CT脑血管造影(3D-CTA)在诊断脑动脉瘤时的注意事项。方法回顾总结3D-CTA检查的106例蛛网膜下腔出血(SAH)病例,其中14例初次3D-CTA显示动脉瘤不清或发现颅内非动脉瘤样血管异常者,对其进行DSA脑血管造影检查。结果初次3D-CTA检查正确诊断脑动脉瘤92例,其中16例为多发脑动脉瘤,共检出115个。余14例因诊断不明确进而实施DSA脑血管造影检查,其中确诊动脉瘤合并烟雾病2例、严重脑血管痉挛致动脉瘤显示不清2例、脑动静脉畸形1例(此5例与3D-CTA所见一致);在3D-CTA扫查范围外发现脑动脉瘤2例。对上述阳性诊断的99例进行手术,并得到证实。另7例在3D-CTA和DSA检查未发现引起SAH的原因病灶,给予保守治疗。结论在脑动脉瘤诊断中,3D-CTA具有较好的精确性。在判断动脉瘤与颅骨位置关系、操作的便捷性和经济性等方面明显优于DSA。在应用3D-CTA对脑动脉瘤进行诊断时,有必要根据患者和设备的具体情况进行个性化设计,方能减少漏诊、误诊。
Objective To discuss the attention points of three-dimensional CT angiography （3D-CTA） in detecting cerebral aneurysms. Methods 3D-CTA was performed on 106 cases. Fourteen of 106 cases also underwent conventional digital subtraction angiography （DSA） due to uncleared diagnosis only by first time 3D-CTA. Results Among the 106 cases, 92 cases （115 aneurysms） were detected at the first 3D-CTA without DSA. DSA was performed on 14 cases suspected had other abnormal during the first 3D- CTA. Two aneurysms were detected in the position out of the 3D-CTA scan area, 2 cases were aneurysms with moyamoya disease, 2 cases were vasospasm and one case was AVM in posterior fossa. The left 7 cases showed normal as same as 3D-CTA findings. Ninety-nine cases with positive findings were conformed by operation. Conclusions 3D-CTA is a simple, quick, and non-invasive technique and superior to DSA in observation the location of aneurysm and skull base. It is necessary to choose whole brain, multiple-phased and indlviduation examination according to different individual. It is also important to pay an attention to the original imaging and read films by neurosurgeons themselves. DSA examination should be performed simultaneously for the complex cases.
出处
《中华神经外科杂志》
CSCD
北大核心
2007年第6期414-417,共4页
Chinese Journal of Neurosurgery
关键词
脑动脉瘤
诊断
三维CT脑血管造影
Cerebral aneurysm
Diagnosis
Three-dimensional CT angiography
