摘要
目的分析CT血管造影对颅内动脉瘤术后夹闭不全的评估效果。方法便利选取2016年1月—2019年1月期间该院就诊的颅内动脉瘤患者40例,CTA检查后行颅内动脉瘤夹闭术,术后复查CTA,发生术后夹闭不全者行二次手术治疗,且在二次术后再次复查CTA,分析检查结果。结果40例颅内动脉瘤患者经手术证实动脉瘤病灶44个,病灶直径<5 mm者14个(31.82%),病灶直径≥5 mm者30个(68.18%);以病位分布于床突动脉及大脑前动脉者居于前两位,分别为45.45%(20/44)、13.64%(6/44);40例颅内动脉瘤患者经术前CTA检出病灶39个,CTA检出率与手术结果符合率88.64%(39/44);40例患者经颅内动脉瘤夹闭术后7 d发生颅内动脉瘤新病灶2枚(均属于同一例患者),载瘤动脉血流比较顺畅;术后10 d发现动脉瘤术后夹闭不全病例3例,经二次手术后行CTA复查,显示动脉瘤夹闭效果良好,载瘤动脉血流比较顺畅;其余36例颅内动脉瘤夹闭效果均比较良好;术后11 d经CTA复查,显示合并脑积水者4例,经脑室腹腔分流术治疗后生命体征稳定,脑血管痉挛及脑梗死各1例,经介入及药物治疗后均明显好转;术后90 d内复诊,颅内情况均良好。结论CT血管造影对颅内动脉瘤术后夹闭不全的诊断及手术效果评估价值均较好。
Objective To analyze the effect of CT angiography on the evaluation of cerebral insufficiency after intracranial surgery.Methods Forty patients with intracranial aneurysms treated in the hospital from January 2016 to January 2019 were convenient selected.After CTA examination,intracranial aneurysm clipping was performed,and CTA was re-examined after surgery.Those with postoperative clipping insufficiency were performed twice surgical treatment and re-examination of CTA after the second postoperative period to analyze the test results.Results 40 patients with intracranial aneurysms were diagnosed with intracranial aneurysm lesions by 44,14 lesions(31.82%)with lesion diameter<5 mm,and 30 patients(68.18%)with lesion diameter≥5 mm.The anterior and posterior cerebral arteries were the first two,45.45%(20/44)and 13.64%(6/44)respectively;40 patients with intracranial aneurysms detected 39 lesions by preoperative CTA,and CTA detected.The rate of coincidence with the surgical outcome was 88.64%(39/44);40 patients developed 2 new lesions of intracranial aneurysms 7 d after intracranial aneurysm clipping(all belonging to the same patient),with smooth blood flow in the aneurysmal artery.At 10d after surgery,3 cases of postoperative clipping insufficiency were found.After the second operation,CTA reexamination showed that the clipping effect of aneurysm was good and the blood flow of parental artery was smooth.The other 36 cases of intracranial aneurysms had good clipping effect.11 d after the operation,CTA reexamination showed that 4 cases were complicated with hydrocephalus.After ventriculoperitoneal shunt treatment,vital signs were stable,cerebral vasospasm and cerebral infarction were 1 case respectively.Within 90 d after the operation,the intracranial conditions were all good.Conclusion CT angiography has a good value in the diagnosis and surgical evaluation of intracranial aneurysm after operation.
作者
王凤
杨华园
杨扬
赵小话
WANG Feng;YANG Hua-yuan;YANG Yang;ZHAO Xiao-hua(Department of Medical Imaging,Qingzhou People's Hospital,Qingzhou,Shandong Province,262500 China;Department of Neurology,People's Hospital of Shouguang City,Shouguang,Shandong Province,262700 China)
出处
《中外医疗》
2020年第9期180-182,共3页
China & Foreign Medical Treatment
