目的评价16层螺旋CT血管成像(CTA)在颅内动脉瘤诊断的准确性和确定其能否提供足够的诊断信息来指导血管内治疗。方法329例临床怀疑颅内动脉瘤的患者纳入本研究,全部行CTA和DSA检查。运用最大密度投影和容积再现技术评价动脉瘤的形态、大小、位置和动脉瘤与周围血管的关系,并根据16层螺旋CTA结果选择血管内治疗或外科治疗。结果329例中的181例患者发现202个颅内动脉瘤。4个动脉瘤CTA漏诊,而DSA检查过程中7个动脉瘤未能清楚显示。16层螺旋CTA诊断所有动脉瘤的敏感性、特异性和准确性分别是98%、98%和98%。16层螺旋CTA对于动脉瘤诊断的准确性与DSA的结果差别没有统计学意义。通过CTA评价认为115个动脉瘤适合行血管内治疗,结果112个动脉瘤成功栓塞。结论16层螺旋CTA在诊断颅内动脉瘤方面有很高的准确性,能够提供有价值的信息指导动脉瘤的血管内治疗。 Objective To evaluate the accuracy of 16-slice spiral CT angiography (CTA) in the diagnosis of intracranial aneurysms and to determine whether it can provide enough diagnostic information to guide the endovascular treatment. Methods A total of 329 patients with suspected intracranial aneurysms were enrolled in this study. All patients underwent CTA and DSA. The maximum density projection and volume rendering techniques were used to evaluate the morphology, size and location of the aneurysms and the relationship between the aneurysms and the surrounding blood vessels. Endovascular or surgical treatment was performed according to the results of 16-slice spiral CTA. Results A total of 202 intracranial aneurysms were found in 181 of the 329 patients. Four aneurysms were missed by CTA and seven aneurysms were not clearly demonstrated during DSA. The sensitivity, specificity and accuracy of 16-slice CTA in the diagnosis of all aneurysms were 98%, 98% and 98%, respectively. The accuracy of 16-slice CTA in the diagnosis of aneurysms was not statistically different from that of DSA. According to CTA evaluation, 115 aneurysms were suitable for endovascular treatment, resulting in successful embolization of 112 aneurysms. Conclusion 16-slice CTA has high accuracy in the diagnosis of intracranial aneurysms and can provide valuable information to guide the endovascular treatment of aneurysms.