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1、AbstractObjective:Theaimofthisstudywastoassesstheusefulnessof64detectorrowcomputedtomographicangiography(CTA)inidentifyningandevaluatingcerebralanurysmsbycomparingitwithdigitalsubtractionangiography(DSA)andpartlywithintraopreativefindings-Methods:Duringa27-monthperiod
2、(December2007andFebruary2010),54patientswithclinicalsuspectedcerebralaneurysmswereprospectivelyrecruitedtothisstudyandunderwent64-detectorCTAandDSA.47ofthemwhohighlysuspectedcerebralaneurysmsunderwentclipingofanerurysmsoperation.Weenrolled54consecutivepatients(31men,2
3、3women),withameanageof54years(rage39-75),36ofthemhadsubarachnoidhaemorrhage,11ofthemhadworseningheadache,6ofthemhadcerebralhemorrhage,1ofthemhadsingleoculomotornervepalsy・64-detectorCTAimagesanalysiswereperformedinteractivelybytheradiologistusedvariouspostprocessingte
4、chniques,mainlyusedvolumerendering(VR)andmaximumintensityprojections(MIP).UsingVRandMIPtoshowtheshape,thrombusandcalcificationandparentvesselofaneurysm,comparingwithDSA.Results:54patientswhowerefound55aneurysmsbyDSA,atotalof57aneurysmsweredetectedbyCTA.Thesensitivity,
5、specificityandcoincidencerateofCTAwere96.4%,70%and92.4%.ThepositivepredictvalueandnegativepredictvalueofMSCTAwere94.7%and力.7%.7patientswhounderwendDSAandCTAdectedwerenegative・TwoaneurysmslocatedatthecavernoussinusofcarotidarteryandthevertebralarteryweremissedbyCTA・Ove
6、rall,CTAidentified57aneurysms,themeandiameterwas6.4mm,themaximumwas18mmlocatedatanteriorcommunicatingartery,theminimumwas1Jmmlocatedattheleftcarotidartery.VRandMIPshowed6(10.5%)aneurysmswhosediameterwasunder2mm,4(7%)aneurysmswhosediameterwasbetween2mmand3mm,39(68.4%)a
7、neurysmswhosediameterwasbetween3mmand10mm,8(14%)aneuiysmswhosediameterwasabove10mm.Thereisnodifferenceinmeasuringaneurysms'sneckandlongdiameteramongVR,MIPandDSA(P>0.05).Inaddition,CTAwassignificantlysuperiortoDSAindepictinganeurismalmorphologyandevaluatingthebranching
8、pattern,neckgeometry,andpresenceandextentoftheaneurismalthrombusandclacification.Theaneurysmsandtheirsurroundingstructureswe