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目的:研究螺旋CT血管造影(CTA)不同重组方法对颅底动脉瘤的诊断价值。方法:对43例原发性蛛网膜下腔出血(SAH)的动脉瘤疑似患者行CTA和DSA,由2位经验丰富医生阅片,作双盲对照研究。CTA后处理采用容积再现(VR)、最大密度投影(MIP)、表面遮盖法(SSD),辅以调整CT阈值和精细去颅底骨方法。结果:43例SAH中动脉瘤37例40个,均经DSA证实,其中17个手术切除,21个介入栓塞,2个未作处理。CTA发现动脉瘤36例38个。对动脉瘤体径>3mm者,CTA与DSA检出率相仿;VR能发现体径为1.72mm的微小动脉瘤。结论:CTA能精确显示其三维空间形态,对直径>3mm动脉瘤,CTA与DSA效能相仿,在VR、MIP、SSD三种技术中以VR品质最优,能发现颅底微小动脉瘤。
Objective: To study the diagnostic value of different reconstruction methods of spiral CT angiography (CTA) for skull base aneurysm. Methods: CTA and DSA were performed in 43 patients with suspected aneurysm of primary subarachnoid hemorrhage (SAH). Two experienced physicians performed the double-blind controlled study. CTA postprocessing uses volume rendering (VR), maximum density projection (MIP), surface masking (SSD), supplemented by adjustments to CT thresholds and subtle skull base. Results: Forty-three aneurysms of SAH were identified in 37 cases and 40 of them were confirmed by DSA. Among them, 17 were resected, 21 were involved in embolization, and 2 were not treated. CTA found aneurysms in 36 cases 38. For aneurysm body diameter> 3mm, CTA and DSA detection rate similar; VR can be found in the body diameter of 1.72mm small aneurysms. CONCLUSION: CTA can accurately display its three-dimensional spatial morphology. For aneurysms> 3mm in diameter, CTA and DSA have similar efficacy. VR is the best in VR, MIP and SSD, and cranial base microaneurysm can be found.