目的评价三维CT血管造影(3D-CTA)在破裂颅内动脉瘤早期栓塞治疗中的临床意义。方法 50例高度怀疑为动脉瘤性蛛网膜下腔出血患者,早期行3D-CTA检查,根据检查结果初步评估颅内动脉瘤的形状和大小,与载瘤动脉关系,据此制订介入栓塞治疗方案(单纯弹簧圈栓塞,球囊或支架辅助弹簧圈栓塞),随后行DSA检查并同期行动脉瘤栓塞治疗。结果 50例患者共52枚动脉瘤(3D-DSA检查和术中证实),经3D-CTA检出51枚,1例微小动脉瘤在3D-CTA上未能显影。依据3D-CTA检查结果制订的介入栓塞方案疗效满意。结论 3D-CTA对颅内破裂动脉瘤诊断,制订早期介入治疗方案具有十分重要的意义。 Objective To evaluate the clinical significance of three-dimensional CT angiography (3D-CTA) in early embolization of ruptured intracranial aneurysms. Methods Fifty patients highly suspected as having aneurysmal subarachnoid hemorrhage underwent early 3D-CTA examination. The shape and size of the intracranial aneurysm, and the relationship with the parent artery were preliminarily assessed based on the results of the examination. Interventional embolization regimen (Simple coil embolization, balloon or stent-assisted coil embolization) followed by DSA and aneurysm embolization in the same period. Results A total of 52 aneurysms were confirmed in 50 patients (3D-DSA and intraoperative confirmation). Fifty-one aneurysms were detected by 3D-CTA. One case of aneurysm failed to develop on 3D-CTA. Efficacy of interventional embolization based on 3D-CTA results was satisfactory. Conclusion 3D-CTA is very important for the diagnosis of intracranial ruptured aneurysms and the development of early interventional therapy.