论文部分内容阅读
目的探讨去骨减影3D-CTA在脑动脉瘤夹闭术后评价中的应用价值和潜在缺陷。资料与方法对41例46个脑动脉瘤夹闭后的头颅CTA图像回顾性分析,分别采用去骨减影和非减影CTA评价动脉瘤夹闭后有无瘤颈残留、载瘤动脉是否通畅及动脉瘤夹闭术后其他并发症,并比较两种方法的优缺点。结果3D-CTA清晰显示41例46个动脉瘤夹闭术后未见明显瘤颈残留。39例经去骨减影后动脉瘤夹完全减影,且在显示瘤颈残留和载瘤血管及邻近血管上优于未减影图像。38例载瘤动脉通畅,2例可见新的动脉瘤;1例脑动脉痉挛,2例可见动脉瘤夹闭同侧血管闭塞。对动脉瘤颈部夹闭残留显示的敏感性和特异性均为100%,阳性预测值和阴性预测值亦均为100%;检测载瘤动脉通畅的敏感性和特异性分别为95%和100%,阳性预测值和阴性预测值分别为100%和33.3%。结论双源CT去骨减影3D-CTA是一种安全、无创的检查技术,可准确显示动脉瘤夹闭术后有无瘤颈残留、载瘤动脉的改变、动脉瘤夹的准确位置及颅内术后并发症,并可作为DSA的一种替代。
Objective To investigate the value and potential defects of 3D-CTA in the evaluation of postoperative clipping of cerebral aneurysms. Materials and Methods A retrospective analysis of CTA images of craniocerebral in 41 patients with 46 aneurysms was performed. CTA was used to evaluate the presence or absence of tumor neck after occlusion of aneurysm and whether the parent artery was smooth And other complications after aneurysm clipping and comparing the advantages and disadvantages of the two methods. Results 3D-CTA clearly showed that there were no obvious neck residuals in 41 cases of 46 aneurysms after clipping. Thirty-nine cases underwent complete subtraction of the aneurysm clip after desfracction, and were superior to non-subtracted images in displaying tumor neck and tumor-bearing vessels and adjacent vessels. 38 cases of parent artery unobstructed, 2 cases of new aneurysms can be seen; 1 case of cerebral artery spasm, 2 cases of aneurysm visible ipsilateral occlusion. Sensitivity and specificity for residual aneurysm neck occlusion were 100%, positive predictive value and negative predictive value were both 100%; Sensitivity and specificity of detection of parent artery artery patency were 95% and 100 %, The positive predictive value and negative predictive value were 100% and 33.3% respectively. Conclusion Dual-source CT debridement 3D-CTA is a safe and noninvasive technique that can accurately display the presence or absence of tumor neck, aneurysm changes, aneurysm clip location and cranial Postoperative complications, and as an alternative to DSA.