摘要
目的观察一个心动周期内颅内动脉瘤的搏动情况，探讨动脉瘤出现异常搏动点与破裂的相关性。方法选择2012年2—11月期间行320排四维CT血管成像（4D—CTA）检查35例动脉瘤患者，根据CTA检查结果将患者分为破裂动脉瘤（RIA）组和未破裂动脉瘤（UIA）组。采用东芝Aquilionone320排容积cT扫描，模拟冠状动脉CTA扫描模式，结束后应用原始数据进行重建，一个心动周期内得出时间间隔均为5％的20组数据包，导入软件形成20帧图像，对应心动周期内20个时间段，只有连续3帧及以上图像发现小泡状凸起，且出现在动脉瘤的同一位置，才判定此凸起为异常搏动点。采用SPSS16．0统计学软件对数据进行分析，应用t检验比较分析两组间差异，P〈0．05差异有统计学意义。结果35例患者检出动脉瘤43个。RIA组11例患者共14个动脉瘤，其中发现异常搏动点的动脉瘤11个，未发现者3个；UIA组24例患者共29个动脉瘤，发现异常搏动点的动脉瘤5个，未发现者24个。分别将发现异常搏动点的动脉瘤标记为2，未发现异常搏动点的动脉瘤标记为1，RIA组平均值为1．7±0．4，UIA组平均值为1．1±0．3，t值=4．735，P〈0．001。结论320排CT血管造影在心动周期内观察颅内动脉瘤的搏动并寻找异常搏动点是一种新的检查方法，而异常搏动点可以作为评估颅内动脉瘤破裂风险的重要指标。
Objective To study correlation of aneurysm rupture and abnormal pulsative points of aneurysm impulse by observation of pulsation of intraeranial aneurysm in a single cardiac cycle. Methods 35 aneurysm patients who had taken CTA examination during February to November in 2012 were enrolled, and divided into two groups. One group was ruptured intracranial aneurysm （RIA）, and another group was unruptured intracranial aneurysm （UIA）. Toshiba Aquilion one 320 -row volume CT scanning was used by analog coronary CTA scan mode. Reconstruction was then performed using the ECG - gated reconstruction method with the R - R each interval 5% divided into 20 phases. 20 images were developed after importing software , which were corresponding to 20 periods of time in one cardiac cycle. Abnormal pulsative points of a intracranial aneurysm was judged to be present when the following condition was satisfied ： of the 20 images corresponding to the R - R interval of a single cardiac cycle divided into 20 phases, an elevation in a part of the aneurysm was observed in at least 3 successive frames. All statistical analysis were performed with SPSS software （Version 16. 0）. Comparison the differences between two groups with the use of Chi - square test, differences are statistically significant when P 〈 0.05. Results 43 aneurysms were detected in 35 patients. In RIA group, 14 aneurysms were found in 11 patients which had been detected 11 abnormal pulsative points. In UIA group, 29 aneurysms were found in 24 patients which had been detected 5 abnormal pulsative points. Aneurysms without and with abnormal pulsative points were assigned scores of 1 and 2, respectively. The results for abnormal pulsative points were 1.7 ± 0. 4 in the RIA group and 1.1 ± 0. 3 in the UIA group, t = 4. 735, showing a significantly higher result in the RIA group （P 〈 0. 001 ）. Conclusion It is a new examination technique to find abnormal pulsativepoints of aneurysm in a single cardiac cycle with 320 - row CT angiography, and abnormal pulastive points can be treated as an important index to evaluate the rupture risk of intracranial aneurysm.
出处
《中华神经外科杂志》
CSCD
北大核心
2014年第1期46-49,共4页
Chinese Journal of Neurosurgery
