目的探讨128层螺旋CT三维成 像技术在诊断脑梗死和颅内动脉瘤的价 值。方法 回顾性分析2013年1月-2014年 6月期间222例行128层螺旋CT血管造影 (CTA)检查的脑血管疾病患者的影像学 资料，根据颅内血管异常情况分为正常 组(94例)、脑梗死组(72例)、动脉瘤组 (56例)，对比分析三组患者Willis环血 管变异情况，分析其和脑血管疾病发生 发展的相关性。结果 222例患者Willis 环各组成血管存在诸多变异，变异率为 84.68%，多见ACA-A1、PCA-P1、ACoA、 PCoA变异，脑梗死组A1变异率高于正常 组(P＜0.05)；动脉瘤组ACoA显示率、 A1变异率、PCoA显示率P1变异率、FTP 发生率和脑梗死组及正常组比较差异有 统计学意义(P＜0.05)；正常组Willis 变异率为80.85%、动脉瘤组变异率为 86.11%、脑梗死组变异率为89.29%，组 间比较差异无统计学意义(P＞0.05)。结 论 Willis环变异和脑梗死、动脉瘤等 脑血管疾病密切相关，MSCT三维成像技 术能清晰显示颅底Willis环形态及变异 情况，有助于进一步探析脑血管发病机 制，提高疾病诊断的准确性。

Objective The analysis of 128 slice spiral CT 3D imaging technology and its significance in clinical diagnosis o f cerebral infarction and intracranial aneurysm. Methods Analyzed the 128 slice spiral CT angiography (CTA) data of 222 cases with cerebrovascular disease from 2013 January to 2014 June retrospectively. Intracranial vascular abnormalities were divided into normal group (94 cases), cerebral infarction group (72 cases) and aneurysm group (56 cases), three groups of ratio analysis patients with Willis ring vessel variation, correlation analysis of the occurrence and development of cerebral vascular diseases. Results The components of the circle of Willis vessel had many variations, the variation rate was 84.68%, see ACA-A1, PCA-P1, ACoA, PCoA mutation, A1 mutation in cerebral infarction group were higher than the normal group (P<0.05); aneurysm group ACoA showed significant differences between the rate and A1 rate of mutation, the display rate of PCoA P1 mutation rate and FTP incidence and cerebral infarction group and the normal group (P<0.05); normal group Willis mutation rate is 80.85%, aneurysm group variation rate was 86.11% and the cerebral infarction group variation rate was 89.29%, no significant differences between groups (P>0.05). Conclusion The variation of circle of Willis has close relationship with cerebral infarction and aneurysm, multi slice spiral CT 3D imaging reconstruction can clear display the forms of Willis cirle, which helps to make clear the cerebrovascular pathological mechanism and improve the accuracy rate of diagnosis.