摘要
目的 研究CT血管造影(CTA)对颅 内动脉瘤术后夹闭不全的评估价值。方法 收集我院2015年12月-2017年11月间收治 的45例颅内动脉瘤行开颅夹闭动脉瘤术治 疗的患者,术后均行CTA检查,分析CTA评 估颅内动脉瘤术后闭夹不全的临床价值。 结果 所有患者均于术后7-15d进行CTA复 诊,1例发现新生动脉瘤1枚,再次手术给 予夹闭;2例出现夹闭不全,再次手术调 整瘤夹位置;5例发现脑积水,行脑室腹 腔分流术进行处理;阅片结果除1例图像 质量显示不佳外,其余均可清晰显示载瘤 动脉与动脉瘤夹间的关系、动脉夹数量 与位置、载瘤动脉通畅与否、动脉瘤颈残 留、脑血管痉挛等信息,术后3个月患者 均回院复诊,均显示颅内情况良好。结论 CTA检查具有无创、检查时间短、费用低 等特点,可准确显示动脉瘤夹闭术后颅内 血管、脑实质等情况,在颅内动脉瘤夹闭 术后具有较高的应用价值。
Objective To study the estimated values of CT angiography (CTA) in incomplete clipping after intracerebral aneurysm surgery. Methods 45 cases of patients with intracranial aneurysms treated with neurosurgical clipping in our hospital from December 2015 to November 2017 were collected and were given the CTA examination after operation. The clinical values of CTA in evaluating incomplete clipping after intracerebral aneurysm surgery were analyzed. Results All patients were given CTA return visit at 7-15d for after operation, and 1 case was found with 1 new aneurysm. There were 2 cases with incomplete clipping and reoperation was given to adjust the position of the tumor clip. 5 cases of hydrocephalus were found and treated with ventriculoperitoneal shunt. Except for 1 case with poor image quality of reading results, the rest could clearly show the relationship between the parent artery and aneurysm clips, the number and location of artery clip, whether the parent artery was smooth or not, aneurysm neck residual, cerebral vasospasm and other information. Patients were back to hospital for return visit at 3 months after operation, and all showed good intracranial condition. Conclusion CTA examination has the characteristics of non-invasive, short examination time and low cost. It can accurately display intracranial vascular and cerebral parenchyma after aneurysm clipping, and has high application values after clipping of intracranial aneurysms.
【关键词】CT血管造影;颅内动脉瘤术 后;夹闭不全;评估价值
【中图分类号】R739.41
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2018.06.013
前言
颅内动脉瘤一旦破裂,将引发全身性症状,情况严重时将对患 者神经系统造成不可逆转的损伤,甚至死亡事件[1]。颅内动脉瘤颈夹 闭术可有阻断动脉瘤血供,但该手术后建议患者行影像学检查,探测 瘤块、血管等情况以确认手术效果[1-2]。数字减影血管造影(DSA)检出 图像分辨率高,在血管疾病检查中应用价值较高,但其费用昂贵且有 创[2]。CT血管造影在(CTA)具有无创优势,可准确显示动脉瘤夹闭术 后颅内血管、脑实质等信息,检查速度快且费用低,易被患者所接 受[3]。为研究CTA对颅内动脉瘤术后夹闭不全的评估价值,我院开展如 下研究。
中国CT和MRI杂志
第16卷, 第 6 期
2018年06月
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