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目的:探讨16层螺旋CT血管成像(16SCTA)诊断颅内动脉瘤的价值。方法:对33例16SCTA诊断的颅内动脉瘤进行回顾性分析。其中4例经手术证实,13例经数字减影血管造影(DSA)证实。结果:16SCTA在33例患者中,共发现40个动脉瘤。其中3例为两个动脉瘤,2例为三个动脉瘤。40个动脉瘤中大脑中动脉瘤9个,大脑前动脉瘤8个,大脑后动脉瘤2个,后交通动脉瘤4个,颈内动脉瘤12个,基底动脉瘤3个,胼周动脉瘤1个,小脑上动脉瘤1个。16SCTA均清晰显示瘤体的大小、位置、形态及瘤颈宽度、瘤轴指向、载瘤动脉、动脉瘤与周围重要解剖结构的关系。有DSA资料对照的13例中,16SCTA发现16个动脉瘤中DSA只发现13个,另外DSA发现1个动脉瘤而16SCTA漏诊。16SCTA诊断颅内动脉瘤的敏感度、特异度、阳性预测值、阴性预测值分别为92.9%、97.1%、81.3%、99%。结论:16SCTA在颅内动脉瘤临床诊断和术后随访中有较高的应用价值。
Objective: To investigate the value of 16-slice spiral CT angiography (16SCTA) in the diagnosis of intracranial aneurysms. Methods: A retrospective analysis was performed on 33 cases of intracranial aneurysms diagnosed by 16SCTA. Four of them were confirmed by surgery and 13 were confirmed by digital subtraction angiography (DSA). Results: A total of 40 aneurysms were found in 16 SCTA in 33 patients. Three of them had two aneurysms and two had three aneurysms. 9 of 40 aneurysms, 9 of cerebral aneurysms, 8 of anterior cerebral aneurysms, 2 of posterior cerebral aneurysms, 4 of posterior communicating aneurysms, 12 of internal carotid aneurysms, 3 of basilar aneurysms, 1, 1 on the cerebellum. 16SCTA clearly shows the size, location, shape and tumor neck width, tumor axis, tumor-bearing artery, aneurysm and the surrounding important anatomical structure. Of the 13 patients with DSA data, 16 of 16 aneurysms found only 13 DSAs in DSA and 1 aneurysm in DSA. The sensitivity, specificity, positive predictive value and negative predictive value of 16SCTA in diagnosing intracranial aneurysms were 92.9%, 97.1%, 81.3% and 99%, respectively. Conclusion: 16SCTA has high value in clinical diagnosis and postoperative follow-up of intracranial aneurysm.