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静脉注射对比剂的平板探测器 CT 血管造影在评价和治疗 AcomA 复合体急性破裂动脉瘤中的价值:单中心 15 例经验。

Value of Flat-detector Computed Tomography Angiography with Intravenous Contrast Media Injection in the Evaluation and Treatment of Acutely Ruptured Aneurysms of the AcomA complex: A Single Center Experience in 15 Cases.

机构信息

Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany.

Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.

出版信息

Clin Neuroradiol. 2018 Dec;28(4):545-551. doi: 10.1007/s00062-017-0592-x. Epub 2017 May 5.

Abstract

OBJECTIVE

To illustrate the added value of flat-detector computed tomography angiography with intravenous contrast media injection (intravenous FDCTA) in the evaluation of complex A1/A2/AcomA aneurysms.

PATIENTS AND METHODS

We retrospectively reviewed 15 patients with ruptured aneurysms. In each patient, an intravenous FDCTA was performed and its diagnostic value investigated.

RESULTS

In all patients, FDCTA contributed relevant additional information concerning the anatomy of the A1/A2/AcomA complex and the relationship of the aneurysm neck to these vascular structures, which could not be gained by 2D- and 3D-DSA, and changed the management in 33% of the patients (5 out of 15). In an additional 5 cases, knowledge of the detailed anatomy was helpful to plan the exact stent position.

CONCLUSION

In case of complex A1/A2/AcomA aneurysms, intravenous FDCTA is an effective option to visualize the exact location of the aneurysm neck and the relationship between the aneurysm and the adjacent vessels. Thus, it is of significant added value in the precise planning of a therapeutic strategy.

摘要

目的

阐明静脉注射对比剂的平板探测器 CT 血管造影(intravenous FDCTA)在评估复杂 A1/A2/AcomA 动脉瘤中的附加价值。

患者和方法

我们回顾性分析了 15 例破裂性动脉瘤患者。对每位患者均行静脉 FDCTA 检查,并评估其诊断价值。

结果

在所有患者中,FDCTA 提供了关于 A1/A2/AcomA 复合体解剖结构以及瘤颈与这些血管结构关系的相关附加信息,这是二维和三维 DSA 无法获得的,并改变了 33%(5/15)患者的治疗方案。在另外 5 例中,详细的解剖知识有助于计划确切的支架位置。

结论

对于复杂的 A1/A2/AcomA 动脉瘤,静脉 FDCTA 是一种有效方法,可用于直观显示瘤颈的确切位置以及动脉瘤与邻近血管之间的关系。因此,它在精确制定治疗策略方面具有显著的附加价值。

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