目的 探讨64排螺旋CT血管造影(CTA)诊断颅内多发动脉瘤(MIA)的临床价值.方法 选择25例MIA患者(男9例,女16例,年龄17 ～ 68岁)进行64排螺旋CTA检查,层厚0.625mm,后处理技术包括多层面重建(MPR)、表面遮盖三维重建(3-SSD)、容积显示重建(VR)、最大密度投影重建(MIP),并对照手术及介入栓塞治疗结果评估其临床诊断价值.结果 25例患者经64排螺旋CTA共发现61个动脉瘤,其中2个动脉瘤者17例,3个动脉瘤者6例,4个动脉瘤者1例,5个动脉瘤者1例.64排螺旋CTA能清晰显示MIA,并能清晰显示每个动脉瘤的瘤体大小、瘤颈、瘤顶指向、载瘤动脉以及动脉瘤与周围血管和骨性组织的空间关系.手术治疗21例,介入栓塞治疗4例,64排螺旋CTA所显示的61个动脉瘤的位置、大小、形态及与周围结构的关系与手术和介入栓塞治疗所见一致.结论 64排螺旋CTA诊断MIA准确性较高,可作为MIA的首选诊断方法,且在指导动脉瘤治疗方面可对全脑数字减影血管造影起到重要补充作用.%Objective To evaluate the diagnostic value of 64-slice spiral CT angiography (CTA) in multiple intracranial aneurysms (MIA). Methods Twenty-five patients (9 males and 16 females, aged from 17 to 68 years) with suspected MIA underwent 64-slice spiral CTA with slice thickness of 0.625mm. The data of all patients were reconstructed with multiplanar reconstruction (MPR), 3-dimensional shade surface display (3-SSD), volume rendering (VR) and maximum intensity projection (MIP). The clinical diagnostic value was evaluated with the results of surgery or interventional embolization therapy. Results A total of 61 aneurysms were detected by 64-slice spiral CTA in 25 patients, among them 17 patients were with 2 aneurysms, 6 patients with 3 aneurysms, 1 patient with 4 aneurysms and 1 patient with 5 aneurysms. The 64-slice spiral CTA could not only clearly demonstrate MIA, but also the size, neck, axis point and parent artery of each aneurysm, and the spatial relationship between aneurysm and the adjacent vessels and bone structures. Twenty-one patients underwent microsurgery and four underwent embolization, the location, size and shape of aneurysm and its spatial relationship with adjacent structures were in accordance with the findings of 64-slice spiral CTA. Conclusion The 64-slice spiral CTA could be used as the first choice in the diagnosis of MIA for its high accuracy, and may be an important adjunct to digital subtraction angiography (DSA) in MIA treatment.
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