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目的:探讨多层螺旋CT在脑动脉瘤诊断及治疗方案选择中的临床价值。方法:应用多层螺旋CT脑血管成像(MSCTA)对脑血管图像进行分析,并以数字减影血管造影(DSA)为参考标准,观察动脉瘤的有无、部位、形态、与载瘤动脉、分支及颅底骨结构的关系以及动脉瘤与血肿的关系等,并测量瘤体、瘤颈的大小,计算瘤颈/瘤体比等参数,判断MSCTA的诊断可靠性及其对手术夹闭或栓塞治疗的适应证,为临床治疗提供参考依据。结果:36例患者中,DSA检出动脉瘤32个,MSCTA共检出动脉瘤34个,MSCTA的敏感性为100%,特异性为71.4%,阳性预测值为94.1%,阴性预测值为100%,准确性为87.2%,MSCTA的最大密度投影(MIP)法对脑动脉瘤瘤体最大纵径及瘤颈测量值与DSA测量值比较,无显著性差异(P>0.05)。结论:MSCTA不仅对脑动脉瘤的诊断准确率高,而且对脑动脉瘤治疗方案的选择有一定的参考价值。
Objective: To investigate the clinical value of multi-slice spiral CT in the diagnosis and treatment of cerebral aneurysms. Methods: MSCT was used to analyze cerebrovascular images and digital subtraction angiography (DSA) was used as a reference standard to observe the presence, location and morphology of aneurysms, And the relationship between the structure of the skull base and the relationship between aneurysm and hematoma, and measuring the size of the tumor, tumor neck, tumor neck / tumor ratio and other parameters to calculate, to determine the diagnostic reliability of MSCTA and its closure or Embolization indications for clinical treatment to provide a reference. Results: Of the 36 patients, 32 aneurysms were detected by DSA and 34 aneurysms were detected by MSCTA. The sensitivity and specificity of MSCTA were 100%, 71.4%, 94.1% and 100% respectively %, And the accuracy was 87.2%. There was no significant difference (P> 0.05) between the maximum longitudinal diameter and tumor neck measurement and DSA measurement of MSCTA by MIP. Conclusion: MSCTA not only has high diagnostic accuracy for cerebral aneurysms, but also has certain reference value for the choice of treatment options for cerebral aneurysms.