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目的探讨运用CT血管造影(CTA)诊断破裂脑动脉瘤。方法对怀疑颅内动脉瘤破裂的16例病人施行CTA检查,采用PhilipsTomoscanAVP1螺旋CT机,120kV,200mAs,层厚1.5mm,螺距1,重建间隔0.05mm。造影剂为欧乃派克100ml,2.5~3.0ml/s的速度经肘正中静脉注入,16~18s后扫描。数据经计算机工作站处理后以MIP和SSD法显示,由放射科医师和神经外科医师共同阅片。结果本组16例病人共检出13例16个动脉瘤,其中前交通动脉瘤8例,后交通动脉瘤1例,基底动脉梭形动脉瘤1例,左侧大脑中动脉瘤破裂合并右侧颈内动脉瘤1例,后交通动脉瘤合并同侧颈内动脉床突周围段芽孢状微小动脉瘤2例。10例脑动脉瘤做了开颅手术治疗,术后恢复良好5例,生活自理2例,重度残废2例,植物生存1例。未手术的3例病人,其中1例Hunt-HessⅤ级者术前准备时死亡,1例放弃治疗死亡。1例基底动脉梭形膨大者保守治疗,遗有脑干受压症状。结论CTA具有快速、简便、安全、可靠的优点,可作为破裂脑动脉瘤和急诊手术前首选的检查。
Objective To explore the use of CT angiography (CTA) in the diagnosis of ruptured cerebral aneurysms. Methods CTA was performed on 16 patients with intracranial aneurysm rupture suspected. Philips Tomoscan AVP1 CT scanner was used. 120kV and 200mAs, thickness 1.5mm, pitch 1, reconstruction interval 0.05mm. Contrast agent for the European Nai Park 100ml, 2.5 ~ 3.0ml / s speed by the median vein injection, 16 ~ 18s after the scan. Data were processed by computer workstation and displayed by MIP and SSD methods. Radios and neurosurgeons read the data together. Results Thirteen 16 aneurysms were detected in 16 patients in this study, including 8 cases of anterior communicating artery aneurysm, 1 case of posterior communicating artery aneurysm, 1 case of basilar artery fusiform aneurysm, 1 case of left middle cerebral artery aneurysm rupture 1 case of internal carotid aneurysm, 2 cases of posterior communicating artery aneurysm with sporadic microaneurysm surrounding the ipsilateral internal carotid artery bed. 10 cases of cerebral aneurysms were craniotomy surgery, 5 cases of good recovery after surgery, living in 2 cases, 2 cases of severe disability, 1 case of plant survival. Three patients without surgery, one of which Hunt-Hess grade V were killed preoperative preparation, one patient gave up the treatment of death. One case of conservative treatment of basilar artery fusiform enlargement, left with brainstem pressure symptoms. Conclusion CTA has the advantages of fast, simple, safe and reliable, which can be used as the first choice of ruptured aneurysm and emergency surgery.