Lenhart M, Bretschneider T, Gmeinwieser J, Ullrich O W, Schlaier J, Feuerbach S
Department of Radiology, University of Regensburg, Germany.
Acta Radiol. 1997 Sep;38(5):791-6. doi: 10.1080/02841859709172412.
To evaluate the usefulness of CT angiography (CTA) in the detection of intracranial aneurysms in patients with acute subarachnoid hemorrhage (SAH).
In 53 patients with nontraumatic SAH a helical contrast-enhanced CTA was performed. CTA data were reconstructed with maximum intensity projection (MIP). Each patient underwent selective arteriography of the cerebral vessels (as the gold standard). CTA (axial images and MIP reconstructions) and arteriography were evaluated separately and their diagnostic information was compared.
In 14 of the 53 patients neither CTA nor angiography showed a vascular malformation. In the remaining 39 patients, angiography demonstrated a total of 51 aneurysms ranging in size from 3 mm to 16 mm. CTA missed one of these aneurysms, which was located at the internal carotid artery. 3-D CT reconstruction was slightly superior to arteriography in the demonstration of the neck, shape and direction of the aneurysms. Partial thrombosis of 3 aneurysms was demonstrated only by CTA.
Although CTA cannot replace cerebral arteriography in the diagnostic work-up of acute SAH, it proved to be helpful in demonstrating the topographic anatomy of cerebral aneurysms and surrounding structures.
评估CT血管造影（CTA）在检测急性蛛网膜下腔出血（SAH）患者颅内动脉瘤中的应用价值。
对53例非创伤性SAH患者进行螺旋增强CTA检查。CTA数据采用最大密度投影（MIP）重建。每位患者均接受脑血管选择性动脉造影（作为金标准）。分别对CTA（轴位图像和MIP重建）和动脉造影进行评估，并比较它们的诊断信息。
53例患者中，14例CTA和动脉造影均未显示血管畸形。其余39例患者中，动脉造影共显示51个动脉瘤，大小从3mm至16mm不等。CTA漏诊了其中1个位于颈内动脉的动脉瘤。在显示动脉瘤的颈部、形态和方向方面，三维CT重建略优于动脉造影。仅CTA显示3个动脉瘤存在部分血栓形成。
虽然在急性SAH的诊断检查中CTA不能替代脑血管造影，但它在显示脑动脉瘤的局部解剖结构和周围结构方面被证明是有帮助的。
