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目的探讨3D-CTA与3D-DSA对比在应用于颅内动脉瘤开颅夹闭术后的评估价值。方法针对已行开颅动脉瘤瘤颈夹闭术的30例病人的30个破裂的动脉瘤进行研究。所有病人术后同期行3D-CTA及3D-DSA检查。由两组观察者分别对3D-CTA与3D-DSA影像进行评判,评判动脉瘤是否完全夹闭、载瘤动脉是否通畅。结果3D-CTA影像检查出6例动脉瘤瘤颈残余和1例血管影像异常,经3D-DSA影像证实。3D-CTA漏诊1例瘤颈残余。3D-CTA评价动脉瘤瘤颈残余的灵敏度85.6%,特异度100%;评价载瘤动脉和周围血管狭窄或闭塞的灵敏度100%,特异度96%。结论当使用纯钛动脉瘤夹时,3D-CTA可以替代3D-DSA常规应用于颅内动脉瘤开颅夹闭术后的评估。
Objective To evaluate the value of 3D-CTA compared with 3D-DSA in the treatment of intracranial aneurysms after craniotomy. Methods A total of 30 ruptured aneurysms of 30 patients with craniocervical aneurysm neck dissection were studied. All patients underwent simultaneous 3D-CTA and 3D-DSA examinations. The 3D-CTA and 3D-DSA images were evaluated respectively by two groups of observers to judge whether the aneurysm was completely closed and whether the parent artery was smooth. Results 3D-CTA images of 6 cases of aneurysm neck rupture and 1 case of vascular abnormalities confirmed by 3D-DSA images. One case of tumor neck was missed by 3D-CTA. 3D-CTA evaluation of aneurysm neck residual sensitivity of 85.6%, specificity of 100%; evaluation of the parent artery and peripheral vascular stenosis or occlusion of the sensitivity of 100%, specificity of 96%. Conclusions 3D-CTA can be used as an alternative to conventional 3D-DSA in the assessment of craniotomy occlusion of intracranial aneurysms when using pure titanium aneurysm clips.