- 期刊
- OpenAccess
CT Angiography in the Evaluation of Supraclinoid ICA Aneurysms with Emphasis on Axial Source Images
使用電斷層血管攝影評估床突上部內頸動脈血管瘤：強調軸狀原始影像之重要性
摘要
評估電腦斷層血管攝影應用於診斷床突上部內頸動脈血管瘤，並且強調軸狀原始影像之重要性及SSD和MIP重組影像之優缺點。我們共蒐集了16位經手術證明為床突上部內頸動脈血管瘤之病人，分析他們的電腦斷層血管攝影之影像，並與手術時之發現作比較。在電腦斷層血管攝影影像中，我們將床突上部內頸動脈血管瘤與後交通動脈之關係分為四種類型。第一類型：動脈瘤從後交通動脈長出。第二類型：動脈瘤從後通動脈之遠端長出。第三類型：細小的後交通動脈且與動脈瘤之關係無法確定。第四類型：只看到外突的動脈瘤而看不到後交通動脈。床突上部內頸動脈血管瘤與後交通動脈之關係在電腦斷層血管攝影發現與手術發現之相關率為82%。雖然SSD及MIP之重組影像方式皆可提供類似傳統血管攝影之三度空間立體影像，但是軸狀之原始影像能提供更多資訊，包括動脈瘤的偵測及與其他鄰近血管或骨頭之關係。電腦斷層血管攝影之軸狀原始影像合併SSD及MIP的重組影像能對床突上部內頸動脈血管瘤作很好的術前評估。
並列摘要
To evaluate the application of CT angiography (CTA) for supraclinoid internal carotid artery (ICA) aneurysms and emphasize the importance of axial source images and different benefits of surface-shaded display (SSD) and maximal intensity projection (MIP) reconstruction methods. We retrospectively collected 16 patients with supraclinoid ICA aneurysms confirmed by surgery. The axial source images, SSD and MIP reconstructed images of the CTA were reviewed and correlated with surgical findings. The relationship between the supraclinoid ICA aneurysm and the posterior communicating artery (PCoA) on CTA findings were classified into 4 types in this study. type I: aneurysm from the orifice of the PCoA; type II: aneurysm from the ICA distal to the PCoA; type III: slim and partial PCoA with poor identified relationship between the PCoA and the aneurysm; type IV: only outpouching aneurysm from the supraclinoid ICA without visualization of the PCoA. The correlation rate of the relationship of the PCoA and the supraclinoid ICA aneurysm between CTA and surgical findings was 82%. Although SSD and MIP reconstruction methods can provide a 3D display similar to conventional angiography, the axial source images provide more information about detection and characterization about detection and characterization of supraclinoid ICA aneurysms because there is no overlapping of adjacent vessels and bony structures. The axial source images combined with SSD and MIP reconstruction methods on CTA can provide a good preoperative evaluation of supraclinoid ICA aneurysms.