摘要
目的 评价三维CT血管造影 (3D CTA)在急性动脉瘤性蛛网膜下腔出血 (SAH)患者诊治中的应用价值。方法 回顾性分析 2 9例急性动脉瘤性蛛网膜下腔出血患者 3D CTA、数字减影血管造影(DSA)和手术资料。CTA图像采用遮盖容积重建 (SVR)、最大密度投影 (MIP)、彩色表面阴影显示法(SSD)和CT仿真内窥镜 (VE) 4种处理技术。所得图像分别由两位神经外科医生、两位放射科医生、两位介入科医生评价。结果 3D CTA检出动脉瘤 31个 ,显示瘤体、瘤颈、载瘤动脉和周围血管及颅骨的关系清晰、确切。DSA检出动脉瘤 2 8个 ,漏检 1个大脑前动脉瘤、 1个前交通动脉瘤和 1个后交通动脉瘤。CTA的检出率为 10 0 % ,DSA的检出率为 90 %。两者检出率经 χ2 检验无显著性差异 (χ2 =1 6 1,P =0 4 2 )。 2 9例患者中 ,17例接受手术治疗 ,12例接受血管内栓塞治疗。 3D CTA测得瘤体最大直径 19 7mm ,最小直径1 2mm ,与DSA测量结果比较 ,无显著性差异 (t=1 5 2 ,P =0 33)。结论 对急性动脉瘤性蛛网膜下腔出血患者 3D CTA检出动脉瘤敏感性高、快速、无创 。
Objective To investigate the clinical value of 3D-CTA in the diagnosis of aneurysmal subarachnoid hemorrhage.Methods The data of 3D-CTA,DSA and operation in 29 patients with aneurysmal subarachnoid hemorrhage were reviewed retrospectively.The CTA reconstructed images were processed into shaded volume rendering(SVR),maximal intensity projection(MIP),color shaded surface display(SSD),and virtual endoscopy(VE)images.Images of 3D-CTA and DSA were analysed by 2 neurosurgeons,2 neuroradiologists and 2 interventional neuroradiologists.Results Thirty-one aneurysms were detected by 3D-CTA.Aneurysms body and neck,parent artery,and the relationship between the aneurysms and surrounding structures were accurately displayed.Twenty-eight aneurysms were detected by DSA,and another 3 were not detected.The accuracy rate of 3D-CTA in the diagnosis of ruptured aneurysms was 100%,and that of DSA was 90%.Among the 29 patients, 17 underwent operation treatment,and the results of 3D-CTA is useful operation.Maximal diameter of aneurysms body was 19.7 mm and minimal diameter was 1.2 mm.There were no significant differences between the CTA and DSA in the measurement of the aneurysms.Conclusion 3D-CTA is a sensitive,rapid,and noninvasive method for detecting intracranial aneurysms.3D-CTA may by the first choice for diagnosing intracranial aneurysms,especially in an emergency situation.
出处
《中华急诊医学杂志》
CAS
CSCD
2004年第10期688-690,i004,共4页
Chinese Journal of Emergency Medicine
