目的 探讨多层螺旋CT血管成像 (MSCTA)及其三维重建在颅内动脉瘤(IA) 诊断中的临床应用价值。方法 回顾性收 集2016年11月-2018年4月我院收治的200 例经手术确诊的IA患者MSCTA及DSA图像资 料，对图像进行三维重建，比较MSCTA及 DSA检查对IA检出情况，并比较两种检查 方法所测的瘤体最大径、瘤颈宽度及检查 时间、检查费用。结果 共200例IA患者 中，发现动脉瘤214个；MSCTA术前检出 205个(95.79%)，漏诊9个(4.21%)；DSA检 出210个(98.13%)，漏诊4个(1.87%)；两 种检查方法对动脉瘤检出率比较差异无统 计学意义(P>0.05)；MSCTA与DSA检查下 瘤体最大径、瘤颈宽度比较差异无统计学 意义(P>0.05)；MSCTA检查时间及检查费 用均明显少于DSA，差异有统计学意义(P <0.05)。结论 MSCTA及其三维重建能够清 晰显示瘤体位置、大小及周围空间关系， 对IA的检出率与DSA相当，且具有无创、 快捷、检查费用低等优点，可作为IA检查 的首选方法。

Objective To explore the clinical value of multi-slice spiral CT angiography (MSCTA) and its three-dimensional reconstruction in the diagnosis of intracranial aneurysms(IA). Methods The MSCTA and DSA images of 200 patients with IA which diagnosed by surgery from November 2016 to April 2018 in our hospital were analyzed retrospectively. Three-dimensional post-processing all imagings , and the detection rate of IA was compared between MSCTA and DSA, and the maximal tumor diameter, the tumor neck width, the total examination time and the examination cost were compared between the two examination methods. Results A total of 214 aneurysms were detected in 200 cases, and 205 (95.79%) cases were detected by MSCTA before surgery and 9 (4.21%) cases were missed diagnosis. A total of 210 (98.13%) were detected by DSA and 4 (1.87%) were missed diagnosis. There was no statistically significant difference in the detection rate of aneurysms between the two examination methods (P>0.05). There was no significant difference in the maximal tumor diameter and tumor neck width between MSCTA and DSA (P>0.05). The examination time and examination cost of MSCTA were significantly less than those of DSA (P<0.05). Conclusion MSCTA and the three-dimensional reconstruction can display the location, size and surrounding spatial relationship of aneurysm clearly. The detection rate of IA is comparable to that of DSA, and it has the advantages of non-invasiveness, rapidity, and low examination cost. Therefore it can be used as the first choice for IA examination.