摘要
目的探讨64排螺旋CT血管成像(CTA)对颅内动脉瘤导致蛛网膜下腔出血的诊断价值。方法对75例自发性蛛网膜下腔出血、临床怀疑为颅内动脉瘤患者行64排CTA检查。观察其结果并与脑血管造影(DSA)检查结果对比。结果颅脑CTA检查检出动脉瘤64例,其中6例为可疑动脉瘤,未检出动脉瘤8例,动静脉畸形3例。DSA检查检出动脉瘤60例,未检出动脉瘤12例,动静脉畸形3例。与DSA检查比较,64排CTA对蛛网膜下腔出血病例检出动脉瘤的敏感度为93.7%(60/64),特异性为63.6%(7/11),准确性为85.3%(64/75),漏诊率为5.3%(4/75)。CTA检出动脉瘤的病例中,动脉瘤多发9例,单发55例;其中位于颈内动脉颅内段10例,前交通动脉段20例,大脑中动脉段16例,后交通动脉段23例,椎动脉及基底动脉段10例,大脑前动脉及其他段10例。结论64排CTA诊断伴蛛网膜下腔出血的动脉瘤具有较高的敏感度和特异性;MIP和VR后处理技术对动脉瘤的形态、大小及正常颅脑血管分布有确切及良好的显示。
ABSTRACT:Objective To investigate the value of 64-row CT angiography (CTA)in the diagno-sis of subarachnoid hemorrhage caused by intracranial aneurysm.Methods The 64-row CTA was performed in 75 patients with spontaneous subarachnoid hemorrhage and suspected intracranial aneurysm.The results of 64-row CTA were compared with DSA.Results The CTA showed that 64 patients had aneurysm (6 patients with suspected aneurysm),8 had no aneurysm and 3 had ar-teriovenous malformation.The DSA showed that 60 patients had aneurysm,12 had no aneurysm and 3 had arteriovenous malformation.The sensitivity,specificity,accuracy and missed diagnosis rate of 64-row CTA for aneurysm were 93.7%(60/64),63.6%(7/11),85.3%(64/75)and 5.3%(4/75),respectively.Among the 64 patients with aneurysm detected by CTA,9 had multiple an-eurysms and 55 had single aneurysm.Aneurysms were located in intracranial internal carotid ar-tery in 10 patients,in anterior communicating artery in 20 patients,in middle cerebral artery in 16 patients,in posterior communicating artery in 23 patients,in vertebral or basilar artery in 10 pa-tients,and in anterior cerebral artery in 10 patients.Conclusion The 64-row CTA has high sensi-tivity and specificity for the diagnosis of aneurysm in patients with subarachnoid hemorrhage.The maximum intensity projection (MIP)and volume rendering (VR)post-processing techniques can exactly and excellently display the shape and size of aneurysm and show the distribution of cere-bral blood vessels.
出处
《实用临床医学（江西）》
CAS
2015年第5期71-72,82,共3页
Practical Clinical Medicine
