85例脑动脉瘤多层螺旋CT血管造影、数字减影血管造影的诊断与治疗.pdfVIP

第25卷第6期 广 东 医 学 院 学 报 Vl01．25 No．6 624 2007年 12月 JOURNALOFGUANGIX)NGMEDICALC0LLEGE Dec．20HD7 85例脑动脉瘤多层螺旋CT血管造影、数字减影血管造影的诊断与治疗 李冲云 ，张乃崇 ，蔡 勇 ，李穗燕 ，钟燕洁。，赵瑛枯 ，陈世达 ，林志国 ，黄旅辉 ，贺红艳 ， 李秀梅 (广东省茂名市人民医院1．CT~g；2．神经外科；3．急救中心；4．病案室；广东茂名525000) 摘 要：目的 观察85例脑动脉瘤多层螺旋cr血管造影(MscrA)诊断与治疗的临床价值。方法 对85例脑动脉 瘤行M~-TA、DSA诊断与治疗。结果 85例中MSCTA共诊断出脑动脉瘤95个，DSA诊断出脑动脉瘤96个，术后确诊 为脑动脉瘤96个。MSCTA漏诊1例，诊断符合率为99．0％(95／96)。43例行血管内电解可脱弹簧圈(GDC)栓塞术治疗， 42例行开颅脑动脉瘤夹闭术。84例临床治愈出院，1例行开颅脑动脉瘤夹闭术者术后3d因脑水肿而死亡。结论 MSC— TA是无创伤、安全、快速、简便的脑动脉瘤检查方法，以其诊断结果为依据选择治疗方案效果好，可作为颅内动脉瘤首选 的检查方法。 关键词：体层摄影术，x线计算机；血管造影术，数字减影；颅内动脉瘤 中图分类号：R 739．41；R 814．42 文献标识码：A 文章编号：1005—4057(2007)06．0624—04 Diagnosis and treatment of cerebral aneurysms with MSCTA and DSA LI Chong—yun，ZHANG Nai—chong，CAI Yong，LI Sui—yah，ZHONG Yan-jie，ZHAO Ying．zhe，CHEN Shi—da，LIN Zhi—guo，HUANG Lfi—hui，HE Hong-yan，LI Xiu—mei(DepartmentofCTandNeurosurgeryandFirst一 dCentre and casehisto． ry，Maoming Peopl4s Hospital，Maoming 525000，China) Abstract：Objective To observe the clinical practice of diagnosis and treatment of cerebral aneurysms with MSCTA and DSA．Methods Eighty-five patients with clinically suspected cerebral aneurysms were examined and treated with MSCTA and DSA．Results Among the 96 surgically confirmed cerebral aneurysms in the 85 patients，95 and 96 were diagnosed by MSCTA and DSA．with the exact diagnosis rates of 99％ and 100％．respectively．Forty-three patients were treated by GIX；and 42 were treated by cranioectomy to ligate the aneurysm．Eighty—four patients were cured．One patient died of brain edema 3 days after the surgery．Conclusion MSCTA could be a noninvasive，safe，quick，simple and highly sensitivemethod for the diagnosis and treat— ment of cerebral aneurysms． Key words：tomography；X—ray computed；angiography；digital subtraction；cerebral aneurysm 颅内动脉瘤病常见，约