摘要
目的探讨三维 CT 血管造影(3D-CTA)对颅内动脉瘤的诊断价值,以及对动脉瘤夹闭术后评价其指导价值。方法回顾性分析32例临床怀疑为颅内动脉瘤,并进行了 CT 血管造影(CTA)和数字减影血管造影(DSA)检查的患者,以 DSA 和手术作为参考标准,评价3D-CTA 诊断价值。对其中的5例动脉瘤夹闭病例进行术后评价,术前术后均进行了 CTA 检查,通过比较两次 CTA结果评价动脉瘤夹闭情况。结果根据 DSA 资料及手术结果,CTA 发现颅内动脉瘤的敏感性为100%,特异性为100%,准确性为93.9%。对5例动脉瘤钛夹夹闭术后的患者通过 CTA 进行了随访,与术前 CTA 相比,颅内大血管均未见狭窄或闭塞。结论 3D-CTA 诊断颅内动脉瘤具有较好的特异性和敏感性,以及较好的三维显示能力,是一种可靠、微创的快速诊断颅内动脉瘤的方法,为手术提供了详实的影像学资料,并有助于制定治疗方案。
Objective To assess the values of three-dimensional CT （3D-CT） angiography （3D- CTA） in the diagnosis and operative follow up of intracranial aneurysms after clip. Methods 3D-CTA and DSA were performed on 32 patients with clinical manifestations suggestive of harboring intracranial aneurysms. DSA and operation were regarded as gold standards. Five patients who had been treated with clip underwent CTA both preoperatively and postoperatively to evaluate the effects of aneurysm clipping. Results According to DSA results and surgical findings , the sensitivity , specificity , and the accuracy of 3 D-CTA for the detection of aneurysms were 100 % , 100 % , and 93.9 % respectively. The detection rate of aneurysm with a diameter 〈 3 mm of CTA, with the smallest diameter of 2 ram, was higher than that of DSA, however, there was no significant difference in the detection rate of aneurysm with the diameter 〉 3 mm between CTA and DSA. Postoperative CTA displayed a remnant of aneurysm body in one case. Conclusion With satisfying sensitivity and specificity , 3D-CTA is a quick , reliable , and relatively noninvasive diagnostic tool for intracranial aneurysms. 3D-CTA combined with VR delineates the aneurysmal morphology in detail, and provides useful information for choosing and planning microsurgical or endovascular treatment.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2007年第13期877-880,共4页
National Medical Journal of China
