多层螺旋CT血管造影诊断颅内动脉瘤的临床应用_临床医学论文.docVIP

多层螺旋CT血管造影诊断颅内动脉瘤的临床应用_临床医学论文 多层螺旋CT血管造影诊断颅内动脉瘤的临床应用_临床医学论文 【摘要】 目的 探讨多层螺旋CT血管成像在颅内动脉瘤诊断中的应用价值。 方法 对83例疑为动脉瘤的蛛网膜下腔出血患者急诊行CTA检查，观察其原始图像及VR、MIP、MPR后处理图像，部分病例同DSA、3D TOF MRA或手术所见对照。 结果 发现64例动脉瘤患者共69个颅内动脉瘤（5例患者为2处动脉瘤），其中颈内动脉28例，大脑前动脉3例，前交通动脉14例，大脑中动脉6例，大脑后动脉1例，后交通动脉11例，椎基底动脉6例；并发瘤内血栓3例；钙化2例；伴脑实质血肿15例，脑室积血11例，脑血管痉挛5例。CTA表现与手术结果、DSA、3D TOF MRA基本一致。多层螺旋CT血管成像可充分显示颅内动脉瘤的部位、形态、大小、瘤颈大小、与载瘤血管及临近血管、骨结构的关系、有无瘤内血栓及颅内出血等并发症。 结论 多层螺旋CT血管造影可获得丰富的影像信息，为临床选择治疗方案提供重要依据，并可作为术后复诊的重要手段。 【关键词】 颅内动脉瘤 血管造影 体层摄影术 X线计算机 [Abstract] Objective To investigate the value of MSCT angiography techniques in the diagnosis of intracranial aneurysm. Methods CTA was performed in 83 patients with SAH ,who were suspected to have intracranial aneurysms. The original and reconstructed imaging of VR, MIP, MPR were studied . For particle patients, comparisons were made between the results of CTA and that of DSA, 3D TOF MRA and operation. Results 69 aneurysms were detected in 64 patients (five patients have two aneurysms), of which 28 aneurysms lies in ICA, 3 in ACA, 14 in anterior communicating artery, 6 in MCA, 1 in PCA, 11 in post communicating artery and 6 were in vertebral-basilar artery. 3 cases complicated with thromb, 2 with calcification, 15 with parenchymal haematoma, 11 with hematocele in ventricle and 5 with cerebral angio spasm. The operation results of DSA and 3D TOF MRA were identical to that of CTA. MSCT angiography can clearly demonstrate the locations, shape, size and neck of the aneurysm, together with the anatomic relationship with surrounding vascular and skull bone. Conclusion A bundant imaging information can be obtained through MSCT angiography. It should be used as the important clue for selecting surgical planning and the important methods for long-term follow-up of postsurgical aneurysms. [Key words] intracranial aneurysm; angiography; computed tomography; X-ray computed 蛛网膜下腔出血是神经外科常见的危重急症，颅内动脉瘤破裂是蛛网膜下腔出血的最常见原因，早诊断、早治疗可挽救患者生命、改善预后。DSA一直被公认为是诊断动脉瘤的金标准，但作为一种有创性检查手段，多数学者认为急诊行DSA检查，尤其对