Klingebiel Randolf, Busch Markus, Bohner Georg, Zimmer Claus, Hoffmann Olaf, Masuhr Florian
Dept. of Radiology, Charité, Medical School, Humboldt University, Berlin, Germany.
J Neurol. 2002 Jan;249(1):43-9. doi: 10.1007/pl00007846.
Single-slice computed tomographic angiography (CTA) is an established imaging method for the cerebrovascular system (CVS), but it suffers from technical limitations with respect to the coherent high resolution visualization of longer vascular segments, such as the extra- and intracranial CVS. The recently introduced multi-slice (MS) technology has been attributed with a superior imaging quality for angiographic procedures due to increased scan speed and improved spatial resolution. The purpose of this study was to evaluate the suitability of multi-slice CTA (MS-CTA) for the assessment of the arteriovenous CVS in patients with acute symptoms of either arterial or venous occlusive diseases. 41 patients with clinically suspected acute cerebral ischaemia (hemispheric in 29 and vertebrobasilar in 12 patients) and 4 patients with suspected cerebral venous thrombosis (CVT) underwent CTA in a MS-CT scanner. In addition, doppler ultrasonography (DUS) was erformed in 34, magnetic resonance angiography (MRA) in 5 and digital subtraction angiography (DSA) in 6 patients. All findings were reviewed for stenoses or occlusion of the extra-and intracranial CVS and correlated with the clinical outcome. In 43 (96%) of 45 patients, MS-CTA yielded images of diagnostic quality with comprehensive visualization of the arterial and venous CVS including the cervical carotid bifurcation, the third segment of the major cerebral arteries and the dural sinus as well as internal cerebral veins. In 2 patients, assessment of the carotid bifurcation was limited because of tooth artefacts. In all patients, in whom imaging and clinical follow-up proved a non-lacunar infarction (n = 22), MS-CTA detected the underlying vascular pathology. Suspected CVT could be confirmed in 2 and ruled out in another 2 patients through MS-CTA. In conclusion, multi-slice CT an giography may be a promising new diagnostic tool for the rapid and comprehensive assessment of the arteriovenous CVS in patients with clinical signs of acute cerebrovascular diseases.
单层计算机断层血管造影（CTA）是一种用于脑血管系统（CVS）的成熟成像方法，但在连贯高分辨率显示较长血管段（如颅外和颅内CVS）方面存在技术局限性。最近引入的多层（MS）技术因扫描速度提高和空间分辨率改善，在血管造影程序中具有更高的成像质量。本研究的目的是评估多层CTA（MS-CTA）在评估患有动脉或静脉闭塞性疾病急性症状患者的动静脉CVS方面的适用性。41例临床怀疑急性脑缺血患者（29例为半球性，12例为椎基底动脉性）和4例怀疑脑静脉血栓形成（CVT）患者在MS-CT扫描仪上接受了CTA检查。此外，34例患者进行了多普勒超声检查（DUS），5例患者进行了磁共振血管造影（MRA），6例患者进行了数字减影血管造影（DSA）。对所有检查结果进行了复查，以确定颅外和颅内CVS是否存在狭窄或闭塞，并与临床结果进行关联。45例患者中的43例（96%），MS-CTA获得了具有诊断质量的图像，能够全面显示动脉和静脉CVS，包括颈总动脉分叉、大脑主要动脉的第三段、硬脑膜窦以及大脑内静脉。2例患者因牙齿伪影，对颈动脉分叉的评估受到限制。在所有经影像学和临床随访证实为非腔隙性梗死的患者（n = 22）中，MS-CTA检测到了潜在的血管病变。通过MS-CTA，2例患者的疑似CVT得到确诊，另外2例患者被排除。总之，多层CT血管造影可能是一种有前景的新诊断工具，可用于快速、全面评估具有急性脑血管疾病临床体征患者的动静脉CVS。
