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目的探讨16层螺旋CT三维重组技术评价颅内小动脉瘤(直径≤5mm)的准确性和临床应用价值。资料与方法337例临床怀疑颅内动脉瘤的患者均行16层螺旋CT血管成像(CTA),其三维CT图像与常规DSA和外科手术结果进行回顾性对比研究。三维重组方法为最大密度投影和容积再现技术。结果结合CTA、DSA和术中所见,337例中的84例患者发现95个小动脉瘤。CTA漏诊4个小动脉瘤,DSA漏诊6个小动脉瘤。16层螺旋CTA对于小动脉瘤诊断的准确性与DSA的结果差异无统计学意义。16层螺旋CT三维重组图像可以更准确地显示小动脉瘤的瘤体和瘤颈与周围血管的关系,为小动脉瘤的治疗提供有价值的信息。结论16层螺旋CTA在小动脉瘤诊断方面有很高的准确性,可以作为颅内小动脉瘤筛查的首选影像方法,能够在小动脉瘤的治疗方面提供足够的诊断信息。
Objective To evaluate the accuracy and clinical value of 16-slice spiral CT three-dimensional reconstruction in the evaluation of small intracranial aneurysms (diameter ≤ 5mm). Materials and Methods 337 patients with suspected intracranial aneurysms underwent 16-slice spiral CT angiography (CTA), and their 3D CT images were compared retrospectively with those of conventional DSA and surgical procedures. Three-dimensional reconstruction method for the maximum density projection and volume rendering techniques. Results Combined with CTA, DSA and intraoperative findings, 95 small aneurysms were found in 84 out of 337 patients. CTA missed four small aneurysms, DSA missed six small aneurysms. The accuracy of 16-slice CTA for the diagnosis of small aneurysms was not significantly different from that of DSA. 16-slice spiral CT three-dimensional reconstruction of images can be more accurately show the aneurysm tumor and neck and the relationship between the surrounding blood vessels for the treatment of small aneurysms provide valuable information. Conclusion The 16-slice spiral CTA has high accuracy in the diagnosis of small aneurysms and can be used as the preferred imaging method for screening small intracranial aneurysms. It can provide enough diagnostic information in the treatment of small aneurysms.