颅内动脉瘤术后夹闭不全和载瘤动脉闭塞的64层CTA评价

发布时间：2018-04-18 04:30

本文选题：动脉瘤夹闭不全 + 颅内动脉瘤　；参考：《临床放射学杂志》2016年05期

【摘要】：目的评价颅内动脉瘤术后夹闭不全和载瘤动脉闭塞的CT血管造影(CTA)表现,分析导致夹闭不全和载瘤动脉闭塞的可能原因。方法回顾性分析118例颅内动脉瘤夹闭术后患者的CTA资料,使用64层螺旋CT扫描和多平面重组(MPR)、最大密度投影(MIP)、容积再现(VR)图像后处理技术,并与数字造影血管造影(DSA)对照,评价术后载瘤动脉的CTA表现,尤其是瘤夹的位置、夹闭不成功时残存瘤体的形态。结果 112例载瘤动脉通畅,6例经DSA证实有动脉瘤夹闭不全(5例)和载瘤动脉闭塞(1例)。所有钛夹显示清楚,无伪影。动脉瘤夹闭不全在CTA上表现为瘤夹周围残存小结节状、锥状、泡状或囊袋状动脉瘤影,分别位于前交通动脉处(2例)、右侧大脑中动脉水平段远端分叉处(2例)、左侧大脑中动脉水平段远端分叉处(1例)。1例左侧颈内-后交通动脉瘤夹闭术后载瘤动脉闭塞,CTA表现为相应节段的动脉未见显影。结论 64层MSCTA能清晰显示颅内动脉瘤术后钛合金瘤夹的位置与形态、载瘤动脉的通畅情况以及夹闭不全时残存的动脉瘤。
[Abstract]:Objective to evaluate the CT angiography (CTAA) findings of clipping insufficiency and aneurysm carrying artery occlusion after intracranial aneurysm operation, and to analyze the possible causes of clipping insufficiency and aneurysm carrier artery occlusion.Methods the CTA data of 118 patients after intracranial aneurysm clipping were retrospectively analyzed. The post-processing techniques of 64-slice spiral CT scan, multiplanar recombination MPRA, maximum density projection and volumetric reconstruction were used, and compared with digital angiography (DSA).To evaluate the CTA features of the aneurysm carrier artery, especially the location of the tumor clamp, and the shape of the residual tumor if the clamping was unsuccessful.Results there were 6 cases of aneurysm patency and 1 case of aneurysm occlusion confirmed by DSA in 5 cases.All titanium clips show clear, no artifacts.On CTA, aneurysm clipping was characterized by the presence of small nodules, cones, vesicles or pouch aneurysms around the aneurysm clamp.Two cases were located at the anterior communicating artery, two cases were located at the distal bifurcation of the horizontal segment of the right middle cerebral artery, and one case was located at the distal branch of the horizontal segment of the left middle cerebral artery in 1 case. 1 case was located in the left internal and posterior communicating artery aneurysm clipped after clipping the aneurysm of the left internal and posterior communicating artery.CTA showed no development of the corresponding segment of artery.Conclusion 64-slice MSCTA can clearly show the location and shape of titanium alloy clamp, patency of aneurysm carrier artery and occlusion of incomplete aneurysms after intracranial aneurysm operation.
【作者单位】：湖北省襄阳市中心医院(湖北文理学院附属医)放射影像科;华中科技大学同济医学院附属协和医院放射科;
【分类号】：R651.12;R816.1

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