术中CT在颅内动脉瘤手术中的应用
Academic Journal of Chinese PLA Medical School(2013)
Abstract
目的探讨术中CT在颅内动脉瘤手术中的应用价值。方法收集本院2012年3-7月开颅手术治疗颅内动脉瘤患者20例。在动脉瘤处理前后分别行CT灌注成像(CT perfusion,PCT)及CT血管造影(CT angiography,CTA)扫描,根据两次PCT灌注参数及CTA情况指导手术操作,并将其与体感诱发电位(somatosensory evoked potential,SSEP)及微血管多普勒超声(microvascular doppler ultrasonography,MDU)等常规术中监测手段作比较。结果手术共处理动脉瘤23个,按GOS标准:好19例(95%),差1例(5%)。共行PCT扫描41次,CTA扫描20次,图像质量良好57次(93.4%),差4次(6.6%)。术中CT确认脑灌注异常1例,调整动脉瘤夹位置后恢复;CTA提示无动脉瘤残颈及载瘤动脉闭塞。2例SSEP有明显变化,3例MDU有变化。术后CT平扫均未见术区出血,2例颅内血肿者术后CT平扫提示血肿清除满意。结论术中CT可作为动脉瘤夹闭术中评价动脉瘤是否残留、载瘤动脉及穿支动脉是否狭窄或闭塞的重要检查手段。
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Key words
operative,intracranial aneurysm,intraoperative CT,surgical procedures
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