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目的探讨多层螺旋CT血管造影成像(MSCTA)对脑动脉瘤的诊断及价值。方法MSCTA诊断15例脑动脉瘤,5例行DSA脑动脉造影,2例行电解可脱弹簧圈栓塞治疗。用最大密度投影(MIP)和/或容积投影(VR)法进行血管三维重建,同时行多平面重建(MPR)。结果15例患者中MSCTA发现动脉瘤16个,其中椎动脉2个,基底动脉环5个,大脑前动脉5个,中动脉3个,动脉瘤显示直径3～25mm不等。5例DSA脑血管造影显示4个动脉瘤。CTA三维图像与MPR及原始横断面图像相结合及多角度观察法等对诊断很有帮助。5例行DSA患者CTA所显示动脉瘤位置、大小、是否为峡颈或宽底与DSA结果基本相符。结论MSCTA对脑内动脉瘤显示清晰,三维CTA结合MPR及原始图像可使诊断更准确、客观,为手术或介入治疗动脉瘤提供非常有价值的信息。
Objective To investigate the diagnostic value of multislice spiral CT angiography (MSCTA) in cerebral aneurysm. Methods MSCTA diagnosed 15 cases of cerebral aneurysm, 5 cases of DSA cerebral artery angiography, 2 cases of electrolytic detachable coil embolization. Three-dimensional reconstruction of blood vessels was performed using maximum density projection (MIP) and / or volume projection (VR) while performing multiplanar reconstruction (MPR). Results A total of 16 aneurysms were found in MSCTA in 15 patients, including 2 vertebral arteries, 5 basilar artery rings, 5 anterior cerebral arteries and 3 middle arteries. Aneurysms showed diameters ranging from 3 to 25 mm. Five cases of DSA cerebral angiography showed four aneurysms. CTA three-dimensional images and MPR and the original cross-sectional image combined with multi-angle observation method is very helpful in the diagnosis. 5 DSA patients with CTA showed aneurysm location, size, whether the gorges or broad base and DSA results are basically consistent. Conclusion MSCTA shows a clear cerebral aneurysm. Combined with MPR and original images, 3D CTA can make the diagnosis more accurate and objective and provide valuable information for surgery or interventional aneurysm.