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Study of Multiplanar Spiral Computer Tomography Angiography in Intracranial Unruptured Aneurysms

Author: WangYuFeng
Tutor: ZuoDan
School: Jilin University
Course: Clinical
Keywords: CT CT angiography Intracranial aneurysms Multiple Rupture factors
CLC: R743.3
Type: Master's thesis
Year: 2011
Downloads: 34
Quote: 0
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Abstract


Tumor-like abnormal protrusion of intracranial aneurysms Department of intracranial arterial wall. It is Clinical great harm cerebrovascular disease. Ruptured intracranial aneurysms are often caused by spontaneous subarachnoid hemorrhage (Subarachnoid Hemorrhage. SAH), higher morbidity and mortality, and survivors often have irreversible brain damage. Most of the smaller unruptured intracranial aneurysms with no clinical symptoms, found no symptoms, patients rarely come to the hospital only when the aneurysm rupture, triggering a subarachnoid hemorrhage, patients showed severe headache nausea, clinical symptoms such as vomiting, to the hospital and found intracranial aneurysms. Unruptured intracranial aneurysms, aneurysm or aneurysm that no history of bleeding pathologically confirmed not all aneurysm rupture. With the development of medical imaging, CT angiography (Computerized Tomography Angiography, CTA) are widely used in the diagnosis and evaluation of intracranial aneurysms and unruptured aneurysms are more and more being detected. Order to study the unruptured intracranial aneurysm characteristics, and explore the opportunity and the right method of treating aneurysms, this study, patients with multiple aneurysms as the research object, multislice CT angiography, the comparative analysis of the ruptured aneurysm and unruptured aneurysms The size, shape, position, angle, and other characteristics, and found that the rupture of the difference between the aneurysm and the unruptured aneurysms, summarizes the characteristics of the morphology of aneurysm rupture easily. Multislice CT angiography because of its non-invasive inspection time is short, the advantages of high spatial resolution, has been widely used in the clinical examination. MSCTA by powerful workstations and a variety of advanced image processing technology angiography 3D imaging can figure shows excellent. This study retrospectively analyzed 30 cases of multiple intracranial aneurysms in patients with subarachnoid hemorrhage diagnosed, the line dual source spiral CTA examination. Study 8 males and 22 females, aged 37-73 years, mean age 54.47 ± 9.67 years. The 30 patients, 66 aneurysms, which ruptured aneurysm 34 Ge is not ruptured aneurysm 32 and 30 patients, there are two people more than fat four cases of arterial aneurysm, 2 people and more hair three cases of arterial aneurysm, the rest of each per capita occurred two cases of aneurysm. CT examination, all patients have a subarachnoid hemorrhage, clinical manifestations of sudden headache, nausea, vomiting, stiff neck, and even unconsciousness. This study is divided into two groups, the first group of unruptured aneurysm group, the second group for a ruptured aneurysm group. All patients were treated with dual source spiral CT scanner (Siemens, Germany), the scan sequences Head angiography routine o scan parallel to the baseline listen canthal line. Scan parameters: slice thickness: 0.6mm, pitch: 0.85, rotation time: 0.5sec scan field of view: 200mm scan range: Neck 3 vertebrae to the parietal. Scanning conditions: voltage 120kv, current: 230mA. Scan after the completion of the original data transmitted SIEMENS workstation, using the maximum intensity projection (maximum intensity projection. MIP), and volume rendering techniques (volume rendering, VR) and multiplanar reconstruction (multiplanner reconstruction, MPR) technology, the reconstructed image, and contrast. Results: 1, the diameter of the long diameter of the ruptured aneurysm unruptured aneurysms significant difference (t = - 3.885, P lt; 0.001) diameter grouping than the line of the chi-square test of its constituent still statistically differences. The long diameter of unruptured aneurysms lt; higher than 3mm proportion of ruptured aneurysms. Two sets of wide diameter of the aneurysm, the top neck ratio, the composition of the tumor diameter than the line independent samples T test, P gt; 0.05, not statistically significant. Unruptured aneurysm ruptured aneurysm two groups constitute aneurysms in different locations than a significant difference (X2 = 7.815, P lt; 0.05). Transportation segment in the internal carotid artery, middle cerebral artery, the anterior communicating artery than other locations more prone to aneurysms, its occurrence number of aneurysms purpose of accounting for the total number of aneurysms 86.36%. Traffic segment at the anterior communicating artery, internal carotid artery aneurysm compared compared to other locations aneurysms more prone to rupture, an exception rate was 73.3%, 59.1%, respectively. Unruptured aneurysm shapes constitute differences compared with the rupture of the aneurysm (X2 = 9.748, P lt; 0.05). The hummocky aneurysm compared compared to the other forms, is not prone to rupture. Lobulated saccular aneurysm easier compared to other forms of aneurysm rupture. 4, two sets of aneurysm angle than compared, no statistically significant (X2 = 1.989, P gt; 0.05). Conclusion 1, rupture of intracranial aneurysms in patients 40-60 years of age, the proportion of female patients is higher than the proportion of male patients. The majority of patients with high blood pressure, high blood sugar, smoking and drinking history of the general characteristics of the object of this study. 2, the diameter of the aneurysm is prompted one of the main indicators of aneurysm rupture, aneurysm diameter less than 3mm is not easy to rupture. 3, the location of the aneurysm, the morphology and aneurysm rupture significant anterior communicating artery aneurysm, posterior communicating artery aneurysm rupture prone. Hummocky the aneurysm less prone to rupture. Lobulated saccular aneurysm easier than other forms of aneurysm rupture .4 aneurysm angle with aneurysm rupture rate is no significant correlation.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)
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