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目的 探讨CT、MRA和DSA对颅内动脉瘤的诊断价值。方法 回顾性分析247例颅内动脉瘤病人的临床资料、影像特点。结果 247例患者均经手术证实为动脉瘤。所有患者均行CT扫描检查,发现单发灶性积血161例,多灶性积血9例,并发颅内血肿14例,6例因头部外伤行头颅CT扫描发现动脉瘤。阳性率为71.25％。DSA检查177例,发现动脉瘤166例,阳性率为93.79％。MRI检查140例,其中MRA检查110例,发现动脉瘤131例,阳性率为93.57％。结论 动脉瘤有特征性CT、MRA和DSA表现。CT可动态、无创观察病情变化,有助于早期发现动脉瘤,反映其真实大小,并可了解动脉瘤破裂后的出血量和范围以及脑积水和脑水肿的程度。MRA能显示动脉瘤的全部和周围组织的关系,尤其适用于比较大的动脉瘤。MRA安全且可三维旋转以观察瘤蒂和动脉瘤内的血流情况。CT、MRA和DSA联合应用,有利于对动脉瘤的全面诊断,且彼此不能完全取代。
Objective To investigate the diagnostic value of CT, MRA and DSA for intracranial aneurysms. Methods Retrospective analysis of 247 cases of intracranial aneurysms in patients with clinical data, imaging features. Results All 247 patients were confirmed as aneurysms by surgery. All patients underwent CT scan examination and found 161 cases of single focal hemolysis, 9 cases of multifocal hematoma, complicated by intracranial hematoma in 14 cases, 6 cases of head injury due to head CT scan found aneurysm. The positive rate was 71.25%. 177 cases were examined by DSA, 166 cases of aneurysms were found, the positive rate was 93.79%. MRI examination of 140 cases, including 110 cases of MRA examination found 131 aneurysms, the positive rate was 93.57%. Conclusion Aneurysms have characteristic CT, MRA and DSA manifestations. CT can be dynamic, noninvasive observation of disease changes, help to find aneurysms early, reflecting its true size, and can understand the aneurysm rupture after the amount and extent of bleeding and hydrocephalus and cerebral edema extent. MRA can show the relationship between aneurysm and the surrounding tissue, especially for larger aneurysms. MRA safe and three-dimensional rotation to observe the tumor pedicle and aneurysm within the blood flow. CT, MRA and DSA combined application, is conducive to the comprehensive diagnosis of aneurysms, and can not be completely replaced with each other.