CAJ | 학술논문

目的评价3D-CTA在颅内前循环动脉动脉瘤临床诊疗中的作用.方法回顾性分析2004年6月至2014年6月徐州医学院附属医院神经外科收治的322例前循环动脉动脉瘤患者的3D-CTA、3D-DSA和手术资料.其中有8例3D-CTA显示不清而改行3D-DSA检查;35例手术后应用3D-CTA进行复查.3D-CTA图像采用多层平面重建(MPR)、最大信号密度投影(MIP)、容积再现(VR)、仿真内镜技术(VE)4种处理技术.结果 314例患者3D-CTA显示317个动脉瘤(有3例为多发动脉瘤);另外8例3D-CTA显示不清而改行3D-DSA检查后则能清晰地显示动脉瘤.322例均予开颅显微手术夹闭动脉瘤,术中所见与影像结果一致;有35例手术后6个月行3D-CTA复查显示动脉瘤完全夹闭.结论 3D-CTA是检查颅内动脉瘤高度敏感的无创影像手段,可以作为动脉瘤首选的影像学诊断方法;3D-CTA阴性的蛛网膜下腔出血患者应行DSA检查,以避免漏诊;3D-CTA检查可作为动脉瘤术后随访的首选方法.
목적 평개3D-CTA재로내전순배동맥동맥류림상진료중적작용.방법 회고성분석2004년6월지2014년6월서주의학원부속의원신경외과수치적322례전순배동맥동맥류환자적3D-CTA、3D-DSA화수술자료.기중유8례3D-CTA현시불청이개행3D-DSA검사;35례수술후응용3D-CTA진행복사.3D-CTA도상채용다층평면중건(MPR)、최대신호밀도투영(MIP)、용적재현(VR)、방진내경기술(VE)4충처리기술.결과 314례환자3D-CTA현시317개동맥류(유3례위다발동맥류);령외8례3D-CTA현시불청이개행3D-DSA검사후칙능청석지현시동맥류.322례균여개로현미수술협폐동맥류,술중소견여영상결과일치;유35례수술후6개월행3D-CTA복사현시동맥류완전협폐.결론 3D-CTA시검사로내동맥류고도민감적무창영상수단,가이작위동맥류수선적영상학진단방법;3D-CTA음성적주망막하강출혈환자응행DSA검사,이피면루진;3D-CTA검사가작위동맥류술후수방적수선방법.
Objective To assess the roles of 3D-CTA in the clinical diagnosis of intracranial anterior circulation aneurysm.Methods The 3D-CTA,3D-DSA and operation data of 322 patients with anterior circulation aneurysm admitted to the Department of Neurosurgery,the Affiliated Hospital of Xuzhou Medical College from June 2004 to June 2014 were analyzed retrospectively.3D-CTA in 8 patients showed unclear and had to perform 3D-CTA examination; and 35 patients were examined by using 3D-CTA after procedure.Four processing techniques of 3D-CTA image were used,including multi-planar reconstruction (MPR),maximum signal intensity projection (MIP),volume rendering (VR),and virtual endoscopy (VE).Results 3D-CTA revealed 317 aneurysms in 314 patients (3 were multiple aneurysms).3D-CTA showed unclear in the other 8 patients and it clearly showed the aneurysms after they performed 3D-DSA examination.Three hundred twenty-two patients were treated with craniotomy and microsurgical clipping of aneurysms.Surgery and imaging results were consistent.3D-CTA showed that the aneurysms of 35 patients were clipped completely at 6 month after procedure.Conclusions 3D-CTA is a highly sensitive non-invasive imaging means for detecting intracranial aneurysms.It can be used as the first choice of imaging diagnosis for aneurysms.3D-CTA negative patients with subarachnoid hemorrhage should perform DSA examination in order to avoid misdiagnosis.3D-CTA examination can be used as the preferred method for follow-up after surgery.