头部64层螺旋CT血管减影成像及在颅内动脉瘤中临床应用.doc

头部64层螺旋CT血管减影成像及在颅内动脉瘤中临床应用[摘要] 目的 探讨头部64层螺旋CT血管减影成像(64-SCTSA)的检查技术及其在颅内动脉瘤中的临床应用价值。方法 回顾性分析32例头部血管64-SCTSA的影像资料，讨论其技术特点及在蛛网膜下腔出血(SAH)中的应用，诊断结果与DSA或手术比较。结果 本组检查及成像参数合理,有效，患者检查成功。32例SAH患者共检出动脉瘤33个，1例64-SCTSA提示动脉瘤1个，DSA显示有2个，1例64-SCTSA未见动脉瘤，5天后复查DSA显示动脉瘤1个。64-SCTSA发现颅内动脉瘤的敏感性为94%,准确性为97%。结论 64-SCTSA技术能减少骨结构等对血管的影响，有利于颅内动脉瘤的显示，使其成为筛查及诊断颅内动脉瘤的首选。 [关键词] 颅内动脉瘤； 血管减影成像； 体层摄影术； X线计算机； 图像处理； 计算机辅助 [中图分类号] R732.2+1 [文献标识码] B [文章编号] 1005-0515（2012）-01-026-01 Clinical Application in Diagnosis of Intracranial Aneurysm and Technique of Head Subtraction Angiography with 64-slice Spiral CT Tang Lin Xia Liming Liu Shutian Zhou Xiaofeng (Department of Radiology,the First People Hospitol of Chang De City Hunan Changde 415003) [Abstract] Objective To discuss the technique and clinical application in diagnosis of intracranial aneurysm of 64-sl ice spiral CT subtraction angiography (64-SCTSA) in headlesions. Methods 32 patients with SAH diseases were examined with 64-SCTSA.The imaging findings were retrospectively analyzed contrasted with surgery of DSA.Results In our study,32 patients with SAH diseases were all examined successfully with the reasonable and effective parameters. 33 intracranial aneurysm in 32 were detected by 64-SCTSA.One aneurysm were showed in one case by 64-SCTSA,but two was showed by DSA.In another one case ,it was normal on 64-SCTSA,but DSA showed one aneurysm after five days.The sensitivity and accuracy of 64-SCTSA in detecting the aneurysms were 94% and 97%.Conclusion 64-SCTSA could show intracranial aneurysm without overlap of bone or tissues,and might be the first diagnostic tool in screening intracranial aneurysms. [Key words] intracranial aneurysm; subtraction angiography; tomography; X-ray computed； image processing;computer assisted 颅内动脉瘤是指颅内动脉管腔的局限性异常扩张[1]。动脉瘤破裂是引起蛛网膜下腔出血(subarachoid hemorrhage SAH)最常见的原因，其预后凶险，病死率高达42-50%[1]。因此及早准确诊断动脉瘤，对临床诊断及治疗有积极意义。64层螺旋CT血管减影成像(64-slice spiral CT subtraction angiography,64-SCTSA)作为一种微创性血管造影方法，已越来