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目的探讨运用CTA诊断破裂脑动脉瘤。方法对怀疑颅内动脉瘤破裂的40例病人施行CTA检查,采用Philips Tomoscan AVP1螺旋CT机,数据经计算机工作站处理后以最大密度投影重建(MIP)和表面遮盖法重建(SSD)法显示,由放射科医师和神经外科医师共同阅片。结果本组40例病人共检出25例28个动脉瘤,其中前交通动脉瘤13例,颈内动脉颅内段动脉瘤3例,后交通动脉瘤2例,大脑中动脉瘤2例,眼动脉瘤1例,基底动脉梭形动脉瘤1例,左侧大脑中动脉瘤破裂合并右侧颈内动脉瘤1例,后交通动脉瘤合并同侧颈内动脉床突周围段芽孢状微小动脉瘤2例。20例脑动脉瘤做了开颅手术治疗,其中15例单纯根据CTA检查结果手术,术中证实诊断。结论CTA具有快速、简便、安全、可靠的优点,可作为破裂脑动脉瘤和急诊手术前首选的检查。
Objective To investigate the diagnosis of ruptured cerebral aneurysm by CTA. Methods CTA was performed on 40 patients suspected of intracranial aneurysm rupture using Philips Tomoscan AVP1 spiral CT machine. The data were processed by a computer workstation and then displayed by maximum density projection reconstruction (MIP) and surface covering reconstruction (SSD) Radiologists and neurosurgeons read the video together. Results Twenty-five aneurysms were detected in 25 patients in this group, including 13 cases of anterior communicating artery aneurysm, 3 cases of internal carotid artery aneurysm, 2 cases of posterior communicating aneurysm, 2 cases of middle cerebral artery aneurysm, 1 case of aneurysm, 1 case of basilar artery fusiform aneurysm, 1 case of left middle cerebral aneurysm rupture with right internal carotid artery aneurysm, 1 case of posterior communicating artery aneurysm with ipsilateral internal carotid artery cystaid sporadic microaneurysm 2 cases. 20 cases of cerebral aneurysms were treated by craniotomy, of which 15 cases based on the results of CTA surgery alone, confirmed by surgery. Conclusion CTA has the advantages of fast, simple, safe and reliable, which can be used as the first choice of ruptured aneurysm and emergency surgery.