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目的评价三维CT血管造影术(3D-CTA)在颅内动脉瘤破裂早期诊断和治疗中的临床应用价值。方法对419例自发性蛛网膜下腔出血病例全部行3D-CTA检查,其中阴性病例再行DSA检查,对确诊为颅内动脉瘤的病例行显微外科手术或介入治疗。结果345例经3D-CTA检查阳性中检出动脉瘤365个,75例阴性病例中DSA证实仅有3例漏诊。348例动脉瘤患者共检测出动脉瘤368个,术中见动脉瘤位置及瘤体、瘤颈和周围解剖结构的关系与术前3D-CTA显示一致。术后病人3D-CTA随访,与术前比较,动脉瘤均夹闭完全、确实。结论3D-CTA是一种方便、可靠、快捷的诊断方法,可以作为颅内动脉瘤破裂诊治的首选影像检查,并且在术中及术后复查随访研究方面也具有重要的临床应用价值。
Objective To evaluate the clinical value of three-dimensional CT angiography (3D-CTA) in the early diagnosis and treatment of ruptured intracranial aneurysms. Methods A total of 419 cases of spontaneous subarachnoid hemorrhage were examined by 3D-CTA. The negative cases were retrospectively examined by DSA and microsurgical operations or interventional therapy were performed on the cases diagnosed as intracranial aneurysms. Results A total of 365 aneurysms were detected in 345 cases with 3D-CTA, and only 3 of 75 cases were missed by DSA. A total of 368 aneurysms were detected in 348 aneurysms. The location of the aneurysm, the location of the aneurysm, the tumor neck and the surrounding anatomy were consistent with the preoperative 3D-CTA findings. Postoperative patients with 3D-CTA follow-up, compared with preoperative, aneurysm are completely closed, indeed. Conclusions 3D-CTA is a convenient, reliable and rapid diagnostic method, which can be used as the first choice of imaging diagnosis and treatment of intracranial aneurysm rupture. It also has important clinical value in intraoperative and postoperative follow-up studies.