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目的探讨三维CT血管造影(three-dimensional CT angiography,3D-CTA)指导颅内前循环动脉瘤早期夹闭手术的价值。方法自发性蛛网膜下腔出血患者28例均于出血48h内行3D-CTA检查,明确前循环动脉瘤破裂诊断后,依据3D-CTA提供的影像学资料,于发病72h内完成动脉瘤夹闭手术。结果 28例患者3D-CTA检查均发现前循环动脉瘤,其中单个动脉瘤26例,2个动脉瘤2例;28例均行动脉瘤夹闭术,术中证实3D-CTA诊断;术后格拉斯哥预后评分分级Ⅴ级6例,Ⅳ级10例,Ⅲ级5例,Ⅱ级5例,Ⅰ级2例。结论 3D-CTA是诊断前循环动脉瘤的一种简便、快速、无创的方法,可为破裂动脉瘤的早期夹闭手术提供可靠影像学资料。
Objective To evaluate the value of three-dimensional CT angiography (3D-CTA) in guiding early clipping of anterior circulation aneurysms in anterior cerebral. Methods 28 cases of patients with spontaneous subarachnoid hemorrhage were examined by 3D-CTA within 48h after hemorrhage. After the diagnosis of anterior aneurysm rupture, based on the imaging data provided by 3D-CTA, aneurysm clipping was completed within 72 hours . Results The anterior circulation aneurysm was found in 28 patients with 3D-CTA. There were 26 aneurysms and 2 aneurysms in 2 patients. The aneurysm occlusion was performed in 28 patients, and 3D-CTA was confirmed during operation. The grade of grade Ⅴ was 6 grade, 10 grade Ⅳ, 5 grade Ⅲ, 5 grade Ⅱ, and 2 grade Ⅰ. Conclusion 3D-CTA is a simple, rapid and noninvasive method for the diagnosis of anterior circulation aneurysms. It can provide reliable imaging data for the early clipping of ruptured aneurysms.