目的分析已破裂颅内动脉瘤在心电监控4D-CTA检查中一个心动周期内的搏动情况,探讨搏动点的临床意义。方法 102例破裂动脉瘤患者行双源CT心电监控4D-CTA检查,将扫描结束后的原始数据进行重组,得出一个心动周期内的时间间隔均为5%的20组数据包,经工作站三维软件处理后,得到20幅图像及动态图。如同一部位连续3幅及以上图像发现小泡状或小尖状凸起,则判定该凸起为搏动点。根据有无搏动点分为有搏动点组和无搏动点组,将两组的临床资料进行统计分析,并将出现搏动点的动脉瘤与手术结果进行对照。结果 102个破裂动脉瘤中81个发现有搏动点,有搏动点组和无搏动点组患者的性别、年龄、发生部位比较无统计学意义(P>0.05),而直径以及瘤颈比在两组之间有统计学意义。在81例有搏动点的动脉瘤中,66例进行了夹闭术,其中62例出血的部位与搏动点的部位一致,且有统计学意义。结论破裂动脉瘤的直径和瘤颈比可能是影响搏动点在心电监控4D-CTA中出现的因素;破裂动脉瘤的搏动点与术中破裂点有较好的一致性,这对破裂动脉瘤的治疗有很大的临床意义。 Objective To analyze the pulsation of a ruptured intracranial aneurysm during a cardiac cycle in 4D-CTA ECG monitoring and to investigate the clinical significance of beating point. Methods A total of 102 patients with ruptured aneurysms underwent dual-source CT 4D-CTA monitoring. The original data after the scan were reconstructed to obtain 20 sets of data packets with a 5% interval in the cardiac cycle. Three-dimensional software processing, get 20 images and dynamic. If three or more consecutive images of the same site were found to have vesicles or small pointed protrusions, the protrusion was judged as a beating point. According to the presence or absence of pulsation point is divided into a pulsatile point group and no pulsatile point group, the two groups of clinical data for statistical analysis, and pulsatile point aneurysm and surgical results were compared. Results There were 81 beat points in 102 ruptured aneurysms. There was no significant difference in the gender, age and location of the patients with and without beat point (P> 0.05) There was statistical significance between groups. Of the 81 aneurysms with pulsatile points, 66 had occlusion, of which 62 had sites of bleeding that were consistent with those of pulsatile points and were statistically significant. Conclusions The diameter and neck-to-neck ratio of ruptured aneurysm may be the influencing factor of beat point in ECG monitoring 4D-CTA. The beat point of ruptured aneurysm is in good agreement with the rupture point of rupture aneurysm, Treatment has great clinical significance.