十六排螺旋CT血管造影在颅内疾病中应用初探

脑血管疾病是危及人体生命的危险疾病。传统的血管造影虽然是诊断该类疾病的最佳方法，但属于有创伤检查，且有1．5％-2．0％的合并症或死亡危险的报导^1]。CT血管造影(computed tomographic angiography cTA)的应用给传统的血管造影带来了极大的挑战。1998年问世的多层螺旋CT(MSCT)以亚秒级的扫描速度具有更长的解剖覆盖、更薄的层厚、多种后处理能力、更简单方便等优势。2002年7月，我院引进GE公司Lightspeed十六排螺旋CT机，并进行了几十例颅内CTA检查，现对其应用情况进行分析。目的：初讨十六排螺旋CT血管造影在颅内病变中的应用及其技术优势。材料与方法：使用GE公司的十六排螺旋CT对自发性脑内出血、动脉瘤、脑肿瘤等几十例病人进行CTA检查，对血管显示情况进行评价；其中AVM和动脉瘤进行DSA检查并与CTA结果比较；另外颜面部AVM及脑肿瘤病人与手术结果比较。结果：CTA检查结果如下，脑血管主干及其1-3级分支显示率为100％，大脑中动脉4—5级分支显示率为94．7％。发现动脉瘤并清晰显示了瘤体、瘤颈、载瘤动脉及其详细关系；AVM清楚地显示了AVM的畸形团及其供血动脉和引流静脉；脑肿瘤显示了肿瘤与周围血管、颅骨间的三维关系。结论：十六排螺旋CT血管造影重建图像质量显著提高，它对颅内各种血管性病变以及血管与颅内其他病变三维空间关系，对各类疾病的诊断具有重要价值，它能显示更细小分支，具备作为动脉瘤等其他血管性病变筛选的首选方法。

Initial study the value of 16-slice spiral CT angiography for intraranial diseases

Purpose:To study the role of 16 slice spiral CT angiography for intracranial diseases and its technique superiority . Materials and Methods:With GE Lightspeed 16 spiral CT Several ten patients clinically diagnosed as spontaneous cerebral hemorrhage, cerebral aneurysms and tumor were performed CTA. The quality of reconstruction images was analyzed. AVM and aneurysms are examined with DSA and compared with CTA. AVM and cerebral tumors are compared with surgery results. Results: The results of CTA of reported ten patients cases as follow: All main trunks and 1 3 branches of cerebral arteries in Several ten cases were well visualized, and 94.7% of 4 5 branches of middle cerebral arteries were well displayed. Aneurysms body, neck, source vessel and their relationship are surely and clearly displayed in aneurysms. In AVM, the vascular malformation and its feeding artery, draining veins are clearly showed. In cerebral tumors, CTA clearly show the tumor, near vessels, skull structure and their relationship. Conclusion: The quality of the image of 16 slice spiral CTA are perfect, and the reconstruction images can display more tiny branches of brain arteries, its value for the diagnosis of cerebral vascular diseases and displaying relationship between intracranial diseases and near vessels is high. We suggested 16 slice spiral CTA can be the first choice for diagnosing cerebral vascular diseases.