摘要
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 evaluate the clinical application and Potential pitfalls of DSCT with boneless subtraction 3D- CTA in the clipped intracranial aneurysms. Materials and Methods The 3D reconstruction of bone subtraction CTA and conventional CTA images of 41 patients with 46 clipped aneurysms were retrospective analyzed. The site of the clip,the pateney of the parent vessel and postoperative complications were evaluated. The advantages and disadvantages of the two methods were compared. Results All the aneurysms were completely clipped on 3D-CTA images. The clips of 39 patients were eliminate completely on bone subtraction CTA images. The details of residual or recurrent aneurysms and parent or neighboring artery were showed clearly on bone subtraction CTA images than subtraction CTA. 38 cases showed vessel patency, 1 case of cerebral artery vasospasm, 2 cases of artery occlusion. For detecting the neck remnant of aneurysm on 3D- CTA, the sensitivity, specificity, tbe positive and negative predictive values were 100%, respectively. For evaluating vessel patency, the sensitivity and specificity were 95% and 100% , and the positive and negative predictive values were 100% and 33.3% , respectively. Conclusion DSCT with bone subtraction 3D-CTA, an ahernative method of DSA, is a safe, non-invasive detective technology , which showed the change of patency of the parent vessel, the exact location of aneurysm clip and intracranial postoperative complication after aneurysms clipping.
出处
《临床放射学杂志》
CSCD
北大核心
2009年第5期704-707,共4页
Journal of Clinical Radiology
关键词
双源CT
去骨减影
3D—CTA
颅内动脉瘤
三维重组
DSCT Bone subtraction 3D-CTA Intraeranial aneuysms Three-dimensional reconstruction
