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Objective: To evaluate 64-slice spiral CT cerebral angiography (CTA) examination performance and clinical value of the diagnosis of intracranial aneurysms with digital subtraction angiography (DSA) to compare the analysis of two checks to their respective advantages. MATERIALS AND METHODS: From December 2007 - February 2010 in our hospital and 54 cases of suspected intracranial aneurysm subjects, were studied retrospectively. All cases were 64-layer MSCTA and DSA, which 47 patients with highly suspected aneurysm the late row aneurysm surgical treatment. This study, 31 males and 23 females, aged 39 to 75 years old, with a median age of 54 years old. Clinical manifestations include subarachnoid hemorrhage in 36 cases, 11 cases of sudden headache, cerebral hemorrhage in 6 cases, unilateral oculomotor nerve palsy 1 cases. 64-slice angiography image quality assessment, major clinical use more shaded volume rendering (VR) and maximum intensity projection (MIP) two post-processing technology, and its neck tumor morphology, intratumoral thrombus, calcification, and the spatial relationship of the parent artery. Results: The group of 54 patients after MSCTA detected 57 aneurysms, including six cases of two aneurysms, 2 cases of three aneurysms, the sensitivity was 96.4%, specificity of 70%, the correct rate of 95.5% positive predictive value of 94.7%, negative predictive value of 77.7%. 55 aneurysms were detected by DSA, including six cases of two aneurysms were three aneurysms; by MSCTA and DSA aneurysms were not detected in a total of seven cases. MSCTA two cases of missed diagnosis of an aneurysm, respectively located in the cavernous segment of the internal carotid artery and vertebral artery. 33 saccular aneurysms in this group of 57 patients with aneurysms, fusiform aneurysm 8, 11 irregular-shaped aneurysm, five miliary aneurysm. This group MSCTA detected 57 aneurysms average diameter of about 6.4mm, where the largest tumor diameter is 18mm, is located in the anterior communicating artery; smallest diameter of 1.7mm, located clinoid segment of the left internal carotid artery. VR and MIP detection of small aneurysms (≤ 2mm in diameter), 10.5% of the total, a small artery aneurysm (2mm lt; diameter ≤ 3 mm) 4 to 7% of the total, aortic aneurysm (3mm lt; diameter ≤ 10mm) 39 accounted for 68.4% of the total, accounting for 14% of the total number of larger aneurysms (diameter gt; 10mm) 8. For the diameter of gt; 2mm aneurysm VR, MIP and DSA detection rate is the same; between the neck of the aneurysm, the accuracy of the measured values ??of the tumor longitudinal diameter, VR, MIP and DSA was no significant difference (P gt; 0.05). , MSCTA parent artery branch vessel relationship and thrombosis, calcification display is significantly better than the DSA seen basically the same and its display of anatomical relationships between the aneurysm and surrounding structures, surgery . Conclusion: 1,64 layer spiral cerebral angiography and DSA in diagnosis of intracranial aneurysms performance is basically the same. For the diameter of gt; 2mm aneurysm VR, MIP and DSA detection rate is the same; no significant differences between the three methods of VR, MIP and DSA in the neck of the aneurysm and tumor longitudinal diameter measurement. 2, the the MIP imaging method and VR imaging method of intracranial arterial aneurysm morphology, tumors in vivo thrombus, calcification and branch vessel displaying superior to DSA. In short, the 64-slice CTA diagnosis of intracranial aneurysms with high sensitivity, the correct rate and specificity. Comparison with DSA, it more competitive in the anatomical relationship of the aneurysm space, which can be used as the technology of choice for intracranial aneurysm screening, diagnosis and preoperative assessment.
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