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目的探讨蛛网膜下腔出血的颅内破裂动脉瘤CT血管造影特点。方法选择自发性蛛网膜下腔出血行头颅CT血管造影(CTA)检查的患者115例。所有患者经外科手术或数字减影血管造影术(DSA)证实为颅内动脉瘤,并进行影像学特点分析。结果 115个破裂动脉瘤中,38个(33.0%)位于前交通动脉,16个(42.1%)伴有一侧大脑前动脉A1段发育不良或缺如;32个(27.8%)位于后交通动脉起始部。动脉瘤最大直径2～17.5(6.72±3.32)mm。37个(32.2%)动脉瘤最大直径<5 mm,72个(62.6%)动脉瘤最大直径<7 mm。颅内破裂动脉瘤体积13～2651(369.65±187.74)mm~3。63个(54.8%)动脉瘤体积<200 mm~3。24个(20.9%)动脉瘤长宽比≤1.8,91个(79.1%)动脉瘤长宽比>1.8。67个(58.3%)动脉瘤伴有子瘤。单发动脉瘤96例(83.5%);多发动脉瘤19例(16.5%),每例有1个责任动脉瘤即破裂动脉瘤,共19个,未破裂动脉瘤23个。破裂动脉瘤最大直径明显大于未破裂动脉瘤(P<0.05)。结论多层螺旋CT能为临床提供颅内破裂动脉瘤丰富的形态学信息。
Objective To explore the characteristics of CT angiography of intracranial rupture aneurysm in patients with subarachnoid hemorrhage. Methods One hundred and fifteen patients with idiopathic subarachnoid hemorrhage underwent cranial CT angiography (CTA). All patients were confirmed as intracranial aneurysms by surgery or digital subtraction angiography (DSA) and analyzed by imaging features. Results Of the 115 ruptured aneurysms, 38 (33.0%) were located in the anterior communicating artery and 16 (42.1%) were accompanied by dysplastic or absent A1 segment of anterior cerebral artery. 32 (27.8%) were located in posterior communicating artery Beginning. The maximum diameter of aneurysms is 2 ~ 17.5 (6.72 ± 3.32) mm. Thirty-seven (32.2%) aneurysms had a maximum diameter of <5 mm and 72 (62.6%) had aneurysms <7 mm in diameter. The intracranial ruptured aneurysm volume of 13 ~ 2651 (369.65 ± 187.74) mm ~ 3.63 (54.8%) aneurysm volume of <200 mm ~ 3.24 (20.9%) aneurysm aspect ratio ≤ 1.8, 91 79.1%) The aspect ratio of aneurysms> 1.8.67 (58.3%) aneurysms with tumor. Single aneurysm in 96 cases (83.5%); multiple aneurysms in 19 cases (16.5%), each case has a liability aneurysm rupture aneurysm, a total of 19, unruptured aneurysm 23. The maximum diameter of ruptured aneurysms was significantly larger than that of unruptured aneurysms (P <0.05). Conclusion Multi-slice spiral CT can provide abundant morphological information for intracranial ruptured aneurysms.