Kumar Ashish, Kato Yoko, Motoharu Hayakawa, Sifang Chen, Junpei Oda, Takeya Watabe, Shuei Imizu, Daikichi Oguri, Yuichi Hirose
Bombay Hospital Institute of Medical Sciences, Department of Neurosurgery, Mumbai, India.
Turk Neurosurg. 2013;23(3):304-11. doi: 10.5137/1019-5149.JTN.5958-12.0.
The role of three-dimensional computed tomography angiography (3D-CTA) in management of aneurysms has been fairly acknowledged in the past. There have been numerous articles in the literature regarding its potential threat to the conventional "gold standard", i.e. digital subtraction angiography (DSA). We study the technology used at a tertiary care hospital in Japan which performs a large number of aneurysm surgeries a year and review the recent literature to gain an insight into the current role of 3D-CTA in detection of aneurysms and if it can be a front line modality of investigation from a neurosurgeon's point of view. At many centres including those in India, DSA is still treated as the first choice of investigation. Although 3D CTA has some limitations, it can provide an unmatched multi-directional view of the aneurysmal morphology and its surroundings including relations with the skull base and blood vessels. This may provide an invaluable help to a neurosurgeon who is usually concerned about many other associated factors involved in approaching an aneurysm.
过去，三维计算机断层血管造影（3D - CTA）在动脉瘤治疗中的作用已得到相当程度的认可。文献中有大量关于其对传统“金标准”即数字减影血管造影（DSA）潜在威胁的文章。我们研究了日本一家三级护理医院所使用的技术，该医院每年进行大量动脉瘤手术，并回顾近期文献，以深入了解3D - CTA在动脉瘤检测中的当前作用，以及从神经外科医生的角度来看它是否可以成为一线检查方式。在包括印度的许多中心，DSA仍被视为首选检查方法。尽管3D CTA有一些局限性，但它可以提供动脉瘤形态及其周围环境（包括与颅底和血管的关系）无与伦比的多方向视图。这可能会为通常关注处理动脉瘤时涉及的许多其他相关因素的神经外科医生提供非常宝贵的帮助。
