電腦斷層血管攝影在診斷顱內動脈疾病的評估

Diagnosis Sensitivity of CT-angiography for Intracranial Arterial Diseases

沈戊忠(Wu-Chung Shen)

《中華放射線醫學雜誌》 23卷6期 (1998/12) Pp. 201-206

摘要

研究電腦斷層血管攝影(CTA)對顱內疾病，尤其動脈瘤及腦血管梗塞的診斷效果。
兩年間我們使用螺旋電腦斷層攝影儀做CTA，其中包括69例疑似動脈瘤患者，17例腦梗塞患者，以及3例腦瘤患者。
對於懷疑動脈瘤者，69例中，52例中找到56個動脈瘤，尤其是自發性蜘蛛網膜下腔出血(SAH)患者，發現動脈瘤比率達88%，（52例中46例有動脈瘤），在腦梗塞方面，則對大動脈梗塞可看到血管阻塞處，至於小梗塞則無診斷價值。
CTA可做為SAH患者或因其他原因懷疑有顱內動脈瘤之診斷工具。對於大動脈梗塞診斷效果很好，但對於小梗塞則無診斷價值。對於腦瘤診斷效果不佳。

關鍵字

電腦斷層攝影 ； 血管攝影 ； 大腦 ； 腦 ； 動脈瘤 ； 蜘蛛網膜下腔出血 ； 腦梗塞

並列摘要

To assess the diagnosis sensitivity and specificity of CT-angiography in intracranial arterial diseases, particularly for aneurysm and arterial occlusion. During the period from July 1996 to July 1998, we performed CT-angiography for intracranial arterial diseases, using spiral CT, in 69 patients with suspicion of intracranial aneurysms, 17 patients with suspicion of brain infarctions, and 3 patients with brain tumors. For the 69 patients with suspected aneurysm, 56 aneurysms were found in 52 patients. Among patients with spontaneous subarachnoid hemorrhage (SAH), 88% had aneurysms. In case of acute cerebral infarctions due to occlusion of the middle cerebral artery (MCA), CT angiography could detect the occlusion site in all cases. However in cases of small infarctions, CT-angiography was not helpful. CT-angiography is the first-line diagnostic tool for spontaneous SAH and for the patients suspected of having intracranial aneurysm due to other symptoms. CT-angiography is also a good diagnostic modality for detecting occlusion of the main artery when the infarction is in the acute stage.

並列關鍵字

CT, angiography ； Aneurysm, cerebral ； Brain, subarachnoid hemorrhage ； Brain, infarction