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[三维计算机断层血管造影多平面重建图像在内侧颈动脉动脉瘤中的临床应用价值]

[Clinical usefulness of multi-planar reconstruction images of three-dimensional computed tomographic angiography for internal carotid artery aneurysms].

作者信息

Nishio Akimasa, Hara Mitsuhiro, Nakamura Kazuhito, Yamauchi Shigeru, Tsuchida Kazuyuki, Inoue Yuichi, Daikokuya Hideo

机构信息

Department of Neurosurgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.

出版信息

No Shinkei Geka. 2002 Mar;30(3):293-9.

Abstract

The usefulness of multi-planar reconstruction (MPR) images of three-dimensional computed tomographic angiography (3D-CTA) for the diagnosis of internal carotid artery (ICA) aneurysms is described. Eleven unruptured ICA aneurysms including six cases of IC-cavernous aneurysm, two cases of IC-ophthalmic artery aneurysm, two cases of IC-posterior communicating artery aneurysm and one cases of IC-anterior choroidal artery aneurysm, were examined by magnetic resonance angiography (MRA), digital subtraction angiography (DSA), 3D-CTA and its MPR images. 3D-CTA and DSA were useful to identify the aneurysmal neck in small aneurysms, but it was difficult to identify the aneurysmal neck in small aneurysms by 3D-CTA-MPR images. DSA and MRA were not useful for identifying the aneurysmal neck in aneurysms more than 10 mm in diameter, as a precise viewing of the neck could not be found due to their large size. For large aneurysms, neither was 3D-CTA useful for identifying the aneurysmal neck when their large size and surrounding bony structures overlapped the aneurysmal neck. On the other hand, 3D-CTA-MPR was very useful for identifying the aneurysmal neck without overlapping by surrounding bony structures. 3D-CTA-MPR images clearly visualized the calcification of the wall. 3D-CTA-MPR images are obtained from 3D-CTA source images without any additional stress to the patients, and they are more useful for the diagnosis as well as demonstration of the aneurysmal neck particularly in more than large aneurysms.

摘要

描述了三维计算机断层血管造影(3D-CTA)的多平面重建(MPR)图像在诊断颈内动脉(ICA)动脉瘤中的作用。对11例未破裂的ICA动脉瘤进行了磁共振血管造影(MRA)、数字减影血管造影(DSA)、3D-CTA及其MPR图像检查,其中包括6例海绵窦段ICA动脉瘤、2例眼动脉段ICA动脉瘤、2例后交通动脉段ICA动脉瘤和1例脉络膜前动脉段ICA动脉瘤。3D-CTA和DSA有助于识别小动脉瘤的瘤颈,但通过3D-CTA-MPR图像识别小动脉瘤的瘤颈比较困难。DSA和MRA对于识别直径超过10mm的动脉瘤的瘤颈无用,因为动脉瘤体积大,无法精确观察到瘤颈。对于大动脉瘤,当瘤体较大且周围骨质结构与瘤颈重叠时,3D-CTA也无法识别瘤颈。另一方面,3D-CTA-MPR对于识别未被周围骨质结构重叠的瘤颈非常有用。3D-CTA-MPR图像能清晰显示瘤壁钙化。3D-CTA-MPR图像由3D-CTA源图像获得,无需给患者增加任何额外负担,尤其对于大动脉瘤,其在诊断和显示瘤颈方面更有用。

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