文档介绍：64层螺旋CT数字减影CTA诊断脑动脉瘤研究
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【摘要】目的探讨64层螺旋CT数字减影CTA诊断脑动脉瘤的价值及局限性。方法自发性蛛网膜下腔出血患者32例完成64层螺旋CT模板扫描和CTA增强扫描后进行数字减影,将减影和常规CTA原始图像分为2组(DSCTA组和常规CTA组),比较2组后处理时间,图像质量及诊断结果的差异。结果 DSCTA组较常规CTA组后处理时间明显缩短;2组对Willis动脉环及其远段脑动脉的重建图像质量及动脉瘤诊断的特异性和敏感性无显著性差异;而对Willis动脉环近段动脉的重建图像质量及动脉瘤诊断的敏感性,DSCTA明显优于常规CTA;常规CTA对血管外病灶显示清楚,而DSCTA与DSA均未能显示。结论 64层螺旋CT数字减影CTA简单、无创、去骨效果良好,综合常规CTA 与数字减影CTA全面分析脑血管情况,效果优于DSA检查,是脑动脉瘤诊断的首选方法。
【关键词】 CT数字减影动脉瘤体层摄影术 X 线计算机
[Abstract] Objective To study the value and limits of 64-row multisection CT digital subtraction angiography (DSCTA) in the diagnosis of intracranial aneurysms. Methods 32 Patients with spontaneous subarachnoid hemorrhage were underwent two same protocols of 64-row multisection CT, unenhanced CT scan and enhanced CTA. DSCTA data was got to the subtract of enhanced CTA and unenhanced CT scan. Data of DSCTA and normal CTA were divided into 2 groups. al difference of reconstruction time, image quality, diagnosis specificity and sensitivity within 2 groups were researched in this study. Results Reconstruction time was significantly reduced and image quality of internal carotid artery, vertebral artery, basilar artery were significant improved using DSCTA. Diagnosis specificity was no significant difference in 2 groups but diagnosis sensitivity of DSCTA in aneurysms below Willis’circle was better than normal CTA. But intracranial focus outside vessel was subtracted in DSCTA and DSA and only showed by normal CTA. Conclusion 64-row multisection CT DSCTA was more effective to eliminate skull and made the diagnosis of intracranial aneurysms below Willis’circle easier, but normal CTA was also important.
[Key words] computed tomography digital subtraction; aneurysm; tomography; X-puted
CTA检查经济、快速、无创,是颅内动脉瘤早期诊断的首选影像学方法,但颅底骨骼的影响限制了其对床突下的动脉瘤的诊断。近年来数字减影CTA(Subtraction CT Angiography, DSCTA)技术的研究取得很大进展,能基本去除大部分病例颅底骨骼对CTA的影响,但研究大多集中在16层螺旋CT而且以回顾性研究为主。64层螺旋CT拥有更快的扫描速度和真正的各向同性,结合数字减影CTA技术,理论上可得到与DSA相媲美的脑血管图像,本文将以常规