摘要
目的分析已破裂颅内动脉瘤在心电监控4D-CTA检查中一个心动周期内的搏动情况,探讨搏动点的临床意义。方法 102例破裂动脉瘤患者行双源CT心电监控4D-CTA检查,将扫描结束后的原始数据进行重组,得出一个心动周期内的时间间隔均为5%的20组数据包,经工作站三维软件处理后,得到20幅图像及动态图。如同一部位连续3幅及以上图像发现小泡状或小尖状凸起,则判定该凸起为搏动点。根据有无搏动点分为有搏动点组和无搏动点组,将两组的临床资料进行统计分析,并将出现搏动点的动脉瘤与手术结果进行对照。结果 102个破裂动脉瘤中81个发现有搏动点,有搏动点组和无搏动点组患者的性别、年龄、发生部位比较无统计学意义(P>0.05),而直径以及瘤颈比在两组之间有统计学意义。在81例有搏动点的动脉瘤中,66例进行了夹闭术,其中62例出血的部位与搏动点的部位一致,且有统计学意义。结论破裂动脉瘤的直径和瘤颈比可能是影响搏动点在心电监控4D-CTA中出现的因素;破裂动脉瘤的搏动点与术中破裂点有较好的一致性,这对破裂动脉瘤的治疗有很大的临床意义。
Objective To investigate the clinical value of pulsative points of ruptured intracranial aneurysm by observing the beating in every Cardiac cycle in the examination of ECG gated four-dimensional CT angiography（ 4D-CTA）.Methods Examinations of ECG gated 4D-CTA of Dual-source CT were used for 102 patients of ruptured intracranial aneurysms. We got 20 sets of data that the time interval are 5% during a cardiac cycle by rebuilding the original data after scanning. Then images and dynamic maps had been got by the processing of workstation of 3D software. We determined the convex portions was the point of impulse if small bubble or small pointed convex could be found in three consecutive or more images at the same site. The 102 patients of ruptured intracranial aneurysms were divided into two groups based on whether having a point of impulse. Then the statistical analysis was performed according to clinical manifestation. Intracranial ruptured aneurysms with pulsation point were compared with surgical resultst. Results There are 81 pulsation points in 102 ruptured aneurysms No significant different between the sex,age and the site of aneurysms of the two groups（ P〈0. 05）,while the aneurysms diameter and the aspect ratio between the two groups were statistical significance（ P〈0. 05）. 66 cases were performedclipping in 81 cases with a pulsative point of aneurysms. We found bleeding areas were accordant with the pulsation points in 62 cases and which were statistical significance. Conclusion The diameter and the aspect ratio appears to be the independent factor whether the pulsative point of aneurysm can be found in 4D-CTA. The point of impulse of ruptured intracranial aneurysm was associated with the point of rupture,which have great clinical significance to treatment of ruptured aneurysms.
出处
《临床放射学杂志》
CSCD
北大核心
2016年第7期984-987,共4页
Journal of Clinical Radiology
基金
江苏省连云港市第一人民医院青年英才豪森基金资助项目(编号:QN150306)
