数字减影CT血管造影对颅内动脉瘤的诊断价值

摘要

Objective:To explore the application value of digital subtraction CT angiography in intracranial aneurysms. Meth-ods:30 cases of intracranial aneurysms proved by CT,DSA and operation were retrospectively reviewed. Aneurysms were ob-served with volume rendering (VR) and maximum intensity projection (MIP). Results:37 aneurysms were detected in 30 pa-tients:6 at anterior communicating artery,2 in the anterior cerebral artery,9 in the middle cerebral artery,16 in the posterior communication artery,2 in the basilar artery,2 in the internal carotid artery. 7 cases manifested multiple aneurysms. Aneurysms were clipped in 7 cases. Aneurysms in 18 patients received Guglielmi detachable coils (GDC) embolization. DSCTA discovered 35 aneurysms with 2 missed. Maximal diameter of the aneurysm was 12 mm×10 mm. Minimal diameter was 3 mm×2.9 mm. The sensitivity,specificity and accuracy of DSCTA were 94.59%,100%,94.59% respectively. Conclusion:DSCTA is an accurate and noninvasive examination that can be performed quickly in the diagnosis of intracranial aneurysms. It demonstrated the high sen-sitivities and specificities in detecting intracranial aneurysms and it has a higher application value in clinical.%目的:探讨数字减影CT血管造影(digital subtraction CT angiography,DSCTA)对颅内动脉瘤的诊断价值.方法:回顾性分析30例颅内动脉瘤合并自发性蛛网膜下腔出血患者的临床及影像学资料,并行MIP、VR观察动脉瘤. 结果:30例共37个动脉瘤,前交通动脉6个,大脑前动脉2个,大脑中动脉9个,后交通动脉16个,基底动脉2个,颈内动脉2个.23例单发,7例多部位动脉瘤. DSCTA共发现35个动脉瘤,漏诊2个. 动脉瘤大小3 mm×2.9 mm~12 mm×10 mm. 18例行弹簧钢圈栓塞. 7例行开颅夹闭术. DSCTA检查的敏感度为94.59%,特异度为100%,准确率为94.59%. 结论:DSCTA是一种快速准确诊断颅内动脉瘤的非侵袭性检查方法,对颅内动脉瘤的检出具有极高的敏感性和特异性,为临床治疗方案的选择提供了可靠依据,有极高的临床价值.