CT血管造影对脑血管性疾病的临床诊断价值

目的评价64层螺旋CT血管成像对脑血管病的诊断及临床应用价值。方法64层螺旋CT血管成像检查确诊脑血管疾病患者60例，50例在1周内行DSA检查。采用减影方法进行后处理，分别得到VR，MIP，TSMIP图像，利用这三种方法重建图像综合评价脑血管病变。结果①脑动脉狭窄或闭塞者46例，其中36例有DSA对照，98．8％的狭窄或闭塞的脑血管与DSA诊断一致，CT血管成像的敏感性，特异性，准确性分别为100％、98．5％、98．8％；②烟雾病3例，均有DSA对照，表现为单侧或双侧大脑中动脉重度狭窄，远端分支异常增多；③脑动脉瘤患者12例，均有DSA对照，后交通动脉瘤7例，前交通动脉瘤3例，大脑中动脉瘤1例，大脑后动脉瘤1例，CT血管成像与DSA显示一致。结论64层螺旋CT层血管成像能快速，准确地诊断各种脑血管疾病，结合减影处理方法提高了诊断的效率和准确性，为临床提供了全面的信息，可作为脑血管疾病患者的首选诊断方法。

The Clinical Diagnostic Value of CT Angiography about Cerebrovascular Diseases

Objective To evaluate the clinical value of 64 - slice spiral CT angiography （CTA） in the diagnosis of cerebrovascular diseases. Methods Sixty patients underwent cerebral 64-slice spiral CT angiography and among them 50 patients also received DSA within a week, we used Subtraction way to treat original imagines and get imagines of VR, MIP, TSMIP which were combination used to diagnosis cerebrovascular diseases. Results （1）Cerebral artery stenosis or occlusion was found in 46 patients, among whom 36 patients also received DSA, with the accordance rate between 64-slices piral CTA and DSA being 98. 18%. The sensitivity, specificity, accuracy are 100%, 98.5 % ,98.8% ;Moyamoya disease was found in 3 patients. CTA added DSA show one or two sides middle cerebral artery strenosis seriously and branch increase anormaly; Twelve patients had cerebral aneurysmsun derwent 64 - slices piral CTA and DSA. Twelve aneurysms were detected by CTA, among which 7 cases were at posterior communicating artery ,3 cases were at anterior communicatingartery, 1 case was at middle cerebral artery, 1 case was at posterior cerebral artery. CTA and DSA diagnosis aneurysms completely coincidence. Conclusion 64-slice spiral CT angiography, a fast non-invasive and effective technique could accurately diagnose common cerebrovascular diseases united digital subtraction angiography. It could provide overall information for treatment planning and could be used as the frist choice for the diagnosis of cerebrevascuiar disease.