卢小文

[摘要]目的 探讨64排螺旋CT血管成像（CTA）在诊断颅内动脉瘤中的应用价值。方法 选取2017年1～8月我院接诊的40例经数字减影血管造影（DSA）确诊的颅内动脉瘤患者作为研究对象。比较分析采取CTA、DSA检查患者的影像资料，评价CTA的优势，包括动脉瘤形态、位置的显示，对附壁血栓、动脉瘤、钙化和周围结构的关系显示。结果 CTA和DSA诊断颅内动脉位置、形态的准确率以及颅内动脉瘤直径大小的准确率比较，差异无统计学意义（P>0.05）。CTA较DSA能够更加清晰地显示颅内动脉瘤的附壁钙化及血栓，较为良好地显示颅内动脉瘤与周围结构的关系，两者比较，差异有统计学意义（P<0.05）。结论 采用CTA诊断颅内动脉瘤，能够清晰地显示颅内动脉瘤的形态、位置、钙化、附壁血栓和与周围结构的关系，可以作为颅内动脉瘤诊断、术前评估的影像学方法。

[关键词]64排螺旋CT；血管成像；颅内动脉瘤；应用价值

[中图分类号] R732.2 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0124-03

[Abstract] Objective To investigate the application value of 64 slice spiral CT angiography （CTA） in the diagnosis of intracranial aneurysms. Methods Altogether 40 cases of patients diagnosed with intracranial aneurysms by digital subtraction angiography （DSA） in our hospital from January to August， 2017 were selected as research objects. The imaging data of patients examined by CTA and DSA were compared and analyzed. The advantages of CTA were evaluated， including the appearance of the aneurysm morphology and location， and the relationship between the wall thrombus， aneurysm， calcification and the surrounding structure. Results The comparsion of accuracy of CTA and DSA in the diagnosis of intracranial artery position， shape and the diameter of intracranial aneurysm were not statistically significant （P>0.05）. Compared with DSA， CTA could clearly show the calcification and thrombus of intracranial aneurysm， and the relationship between intracranial aneurysm and surrounding structure was better， with statistically significant difference （P<0.05）. Conclusion The diagnosis of intracranial aneurysms by CTA can clearly show the shape， location， calcification， wall thrombus and the relationship with the surrounding structure， which can be used as an imaging method for diagnosis and preoperative evaluation of intracranial aneurysms.

[Key words] 64 slice spiral CT； Angiography； Intracranial aneurysm； Application value

颅内动脉瘤是一种发生在颅内动脉管壁上的异常膨出，极易引起患者发生自发性蛛网膜下腔出血。自发性蛛网膜下腔出血的致残率、致死率较高，是一种极为危险的脑血管疾病[1]。近年来，随着人们生活方式和年龄结构的改变，颅内动脉瘤的发病率随之上升，所以对该疾病患者采取及时的诊断十分重要。以往临床上多采取数字减影血管造影（DSA）诊断治疗颅内动脉瘤患者，虽具有一定的效果，但准确率不佳[2]。近年来，64排螺旋CT血管成像（CTA）逐渐被应用于临床相关疾病的诊断当中，其具有无创伤、阴性预测价值高、價格较低且准确率高的优点[3]。因此，本研究选取我院接诊的40例经DSA确诊的颅内动脉瘤患者作为研究对象，旨在探讨CTA在诊断颅内动脉瘤中的应用价值，现报道如下。