Evaluation of the circle of Willis with three-dimensional CT angiography in patients with suspected intracranial aneurysms.
Evaluation of the circle of Willis with three-dimensional CT angiography in patients with suspected intracranial aneurysms.
复制标题
三维 CT 血管造影对疑似颅内动脉瘤患者的 Willis 环进行评估。
DOI：
--
复制
发表时间：
1995
期刊：
影响因子：
--
通讯作者：
W. Maguire
中科院分区：
文献类型：
--
作者：
M. Alberico;S. Patel;B. Casey;W. Jacobs;R. Maguire;R. Alberico;Mahendra Patel;S. Casey;Betsy Jacobs;W. Maguire
目的
确定 CT 血管造影在疑似急性蛛网膜下腔出血或颅内动脉瘤的情况下的有用性。
方法
我们前瞻性地研究了 68 名疑似蛛网膜下腔出血或颅内动脉瘤的患者，首先进行头部平扫 CT，然后立即进行 Willis 环增强螺旋 CT 三维重建。 27 例 CT 发现蛛网膜下腔出血或颅内动脉瘤呈阳性的患者在 CT 血管造影后 12 小时内接受数字减影血管造影或 MR 血管造影评估。 CT/CT 血管造影结果阴性的患者接受腰椎穿刺随访。
结果
CT 血管造影显示 24 个动脉瘤中的 23 个和 2 个动静脉畸形中的 2 个（敏感性，96%；特异性，100%）。动脉瘤大小范围为 2 至 40 毫米（平均 7.9 毫米）。观察者间变异性为 10%。 23例蛛网膜下腔出血中，脑池出血并未限制三维重建。两名 CT 血管造影显示动脉瘤的患者非造影扫描结果正常。
结论
威利斯环 CT 血管造影是评估疑似急性蛛网膜下腔出血和颅内动脉瘤的有用技术。它提供颅内动脉瘤的解剖显示，允许规划传统的血管造影和手术方法。在某些情况下，CT 血管造影可以消除术前常规血管造影的需要。
PURPOSE
To determine the usefulness of CT angiography in the setting of suspected acute subarachnoid hemorrhage or intracranial aneurysm.
METHODS
We prospectively studied 68 patients suspected of having subarachnoid hemorrhage or an intracranial aneurysm with noncontrast CT of the head followed immediately by contrast-enhanced helical CT of the circle of Willis with three-dimensional reconstruction. Twenty-seven patients with CT findings positive for subarachnoid hemorrhage or intracranial aneurysm were evaluated with digital subtraction angiography or MR angiography within 12 hours of CT angiography. Patients with negative CT/CT angiography findings were followed up with lumbar puncture.
RESULTS
CT angiography showed 23 of 24 aneurysms and 2 of 2 arteriovenous malformations (sensitivity, 96%; specificity, 100%). Aneurysm size ranged from 2 to 40 mm (mean, 7.9 mm). Interobserver variability was 10%. In the 23 cases of subarachnoid hemorrhage, cisternal blood did not limit the three-dimensional reconstruction. Two patients with aneurysms on CT angiography had normal noncontrast scans.
CONCLUSIONS
CT angiography of the circle of Willis is a useful technique for evaluation of suspected acute subarachnoid hemorrhage and intracranial aneurysm. It provides anatomic display of intracranial aneurysms, allowing for planning of conventional angiography and surgical approach. In selected cases, CT angiography may eliminate the need for preoperative conventional angiography.