Yang Yun-jun, Chen Wei-jian, Zhang Yong, Wu Zhe-bao, Zhong Ming, Tan Xian-xi, Wu En-fu, Cheng Jing-liang
Department of Radiology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China.
Chin J Traumatol. 2007 Feb;10(1):29-33.
To investigate the diagnostic value of computerized tomographic angiography (CTA) and magnetic resonance angiography (MRA) for intracranial traumatic aneurysms (TAs).
CTA and MRA of six patients with intracranial TAs verified by digital subtraction angiography (DSA) and surgery were retrospectively analysed. All patients were examined by nonenhanced computerized tomography (CT) and two by CTA. The source data were reconstructed by volume rendering (VR) and multi-planar reconstruction (MPR) from CTA. Four of them had maximum intensity project (MIP) from MRA.
Of the six patients, a total of seven TAs were detected by CTA and MRA examinations. Five cases had only one TA and one case had two TAs. The average diameter was 2.3 cm (1.1-3.3 cm). CTA demonstrated two TAs appeared at the cavernous segment of the internal carotid artery (ICA) and the middle cerebral artery (MCA) respectively. MCA TA was definitely and clearly demonstrated on VR images, whereas VR images failed to depict the cavernous ICA TA, which was detected on MPR images. Two TAs were found irregular saccular shape, irregular margin of parent artery and wide neck on CTA. Four MRA examinations demonstrated five TAs, including the cavernous segment ICA TAs (2 cases), the supraclinoid segment ICA TA (1 case), and the cavernous segment associated with opposite side of the petrosal segment ICA TA (1 case). In a cavernous ICA TA, MRA only revealed aneurysm body, whereas aneurysm neck and distal segment of the parent artery were not revealed. In the remaining cases, MRA clearly depicted aneurysm body and parent artery, whereas the neck was not displayed. ICA TAs showed irregular capsule-like high signal intensity on MRA images. Four TAs exhibited irregular distal segment of the parent artery. TAs at the supraclinoid segment or MCA failed to find fracture signs on nonenhanced CT.
Both CTA and MRA examinations are the effective non-invasive method of imageology for diagnosing intracranial TAs, while CTA is more eligible for diagnosing TAs after nonenhanced CT has demonstrated skull base fractures.
探讨计算机断层血管造影（CTA）和磁共振血管造影（MRA）对颅内创伤性动脉瘤（TA）的诊断价值。
回顾性分析6例经数字减影血管造影（DSA）和手术证实的颅内TA患者的CTA和MRA检查结果。所有患者均行非增强计算机断层扫描（CT）检查，其中2例行CTA检查。CTA的源数据采用容积再现（VR）和多平面重建（MPR）技术进行重建。其中4例行MRA的最大密度投影（MIP）重建。
6例患者经CTA和MRA检查共发现7个TA。5例仅有1个TA，1例有2个TA。平均直径为2.3 cm（1.1 - 3.3 cm）。CTA显示2个TA分别位于颈内动脉（ICA）海绵窦段和大脑中动脉（MCA）。MCA的TA在VR图像上显示明确清晰，而VR图像未能显示海绵窦段ICA的TA，后者在MPR图像上被发现。2个TA在CTA上表现为不规则囊状，载瘤动脉边缘不规则且颈宽。4例MRA检查发现5个TA，包括海绵窦段ICA的TA（2例）、床突上段ICA的TA（1例）以及与对侧岩骨段ICA相关的海绵窦段TA（1例）。在1例海绵窦段ICA的TA中，MRA仅显示瘤体，而未显示瘤颈和载瘤动脉的远端。其余病例中，MRA清晰显示瘤体和载瘤动脉，但未显示瘤颈。ICA的TA在MRA图像上表现为不规则的包膜样高信号强度。4个TA的载瘤动脉远端不规则。床突上段或MCA的TA在非增强CT上未发现骨折征象。
CTA和MRA检查均是诊断颅内TA的有效的非侵入性影像学方法，而在非增强CT显示颅底骨折后，CTA更适合诊断TA。
