颅内动脉瘤的比较影像学研究.pdfVIP

放射学实践 2003 年 4 月第 18 卷第 4 期 　Radiol Practice ,Ap r 2003 ,Vol 18 ,No . 4 249 ·中枢神经影像学 · 颅内动脉瘤的比较影像学研究 田锦林 　陈为军 　王宁 【摘要】　目的: 比较分析 DSA 、3D TOF MRA 及 CT 对颅内动脉瘤的诊断价值 。方法 :30 例颅内动脉瘤均经血管造影 和手术证实 ,所有病例均先后作 CT 、3D TOF MRA 及 DSA 检查 ,对其影像学特征进行比较研究 。结果 :DSA 显示全部瘤 ( ) 体 ,呈囊状 、梭形局部突出影 ; 3D TOF MRA 显示 28 个动脉瘤 2 个假阳性 ,4 个未显示 , 其显示动脉瘤 的敏感性为 86 . 7 % ,假阳性为 6 . 7 % 。CT 显示瘤体及蛛网膜下腔出血提示动脉瘤者 15 例 , 占50 % ;无异常者 8 例 , 占26 . 7 % 。结论 : DSA 仍然是诊断颅内动脉瘤的金标准 ;3D TOF MRA 虽然是显示颅内动脉瘤的敏感方法之一 ,但对确定治疗方案价值低 于 DSA ;CT 敏感性较差 ,但可通过显示其间接征象提示动脉瘤 。 【关键词】　脑 ; 动脉瘤 ; 体层摄影术 ,X 线计算机 ; 磁共振成像 【中图分类号】R816 . 2 ; R445 　【文献标识码】A 　【文章编号】100003 13 (2003) Comparison of DSA , MRA and CT in detecting intracranial aneurysms 　TIAN J inlin ,CHEN Weij un ,WAN G Ning. Dep art ment of Radiology ,Baoding PLA 252 Hospital ,Hebei 07 1000 【Abstract 】　Objective :To comp are DSA ,3D TOF MRA and CT in diagnosis of intracranial aneurysm ( IA) . Methods :Thir ty p atient s wit h IA verified by surgery and angiograp hy were studied by CT ,3D TOF MRA and DSA . Their imaging manifesta tions were comp ared . Results :All of 30 aneurysms were identified at intracranial DSA . 28 aneurysms (2 false) were depicted and 4 aneurysms were missed by MRA . Sensitivity and false positive of MRA for detecting IA were 86 . 6 % and 6 . 7 % resp ectively . CT demonstrated aneurysm it self and acute subarachnoid hemorrhage ( SA H) suggesting aneurysm in 15 p atient s ( 50 %) . No a neurysm was found in 8 p atient s (6 . 7 %) on CT scanning. Conclusion :DSA is still t he gold standard for diagnosis of IA . 3D TOF MRA is one of sensitive met hods to identify IA and is cur