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題名 | CT-血管攝影對Willis環動脈及動脈瘤的診斷=Evaluation of the Circle of Willis and Aneurysm Using CT-Angiography |
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作者姓名(中文) | 沈戊忠; 陳昭安; 陳東明; 洪明澤; | 書刊名 | 中國醫藥雜誌 |
卷期 | 2:1 1997.03[民86.03] |
頁次 | 頁37-42 |
分類號 | 415.83 |
關鍵詞 | Internal carotid arteries; ICA; CT-血管攝影; 動脈瘤; 蜘蛛網膜下腔出血; CT-angiography; Aneurysm; Subarachnoid hemorrhage; |
語文 | 中文(Chinese) |
中文摘要 | 本研究目的是研究CT-血管攝影(CTA)對circle of Willis血管的顯示情形,以及對蜘蛛網膜下腔出血(SAH)患者,使用CT-血管攝影的診斷效果。我們做了16例顱內的CTA,其中8例是SAH,4例腦梗塞,2例腦出血,2例是第三對顱神經麻痺。我們使用Picker PQ 2000 Spiral CT。由蝶鞍底之下1公分往上,以2mm切面,連續切30張,共6公分範圍,CT躺床以2mm/sec移動,由前肘靜脈注射80-90ml含碘顯影劑,每秒注射3ml,注射顯影劑後5秒開始做CT切片。所有資料傳給SUN電腦工作站,做3-D影像重組,使用surface-rendering方法做出CTA。對所有16例Willis環,我們發現Willis環有下列變異:(一) 缺1條PCoA,雙側PCA共用1條PCoA者有6例,(二)ACA缺A1部份,而藉由對側ACA經由ACoa供應者有2例,(三)ACA的A1發育不良,又藉對側ACA經ACoA供應者2例。8例SAH中,7例可精確診斷出動脈瘤,1例沒有發現,與傳統血管攝影所見相同。而且CTA提供更立體的影像,且有周圍骨頭構造可供對照其位置,對於外科醫師手術計劃幫忙甚大,甚至優於傳統血管攝影。我們的結論是:CTA對 Willis環及其內的動脈瘤診斷性相當高,而且提供周圍顱底骨頭構造相對稱的三度立體空間影像。CTA將可取代傳統血管攝影對顱內大血管疾病的診斷。 |
英文摘要 | Purpose: We report our experience with CT-angiography (CTA) in the evaluation of the normal anatomy of the circle of Willis and the aneurysms in this circle. Subjects and Methods: Eight patients with spontaneous subarachnoid hemorrhage (SAH) and eight patients with TIA, minor stroke, intracerebral hemorrhage or third cranialpalsy, received CTA evaluation. Using a Picker PQ2000 spiral CT scanner for imaging collection and a SUN workstation for imaging analysis. The scan beginning 10mm below the sellar floor and covering a total area of 60mm. The circle of Willis and the middle and anterior cerebral arteries were included in the scan area. Three-dimensional CT reformations were obtained using the surface rendering method. For comparison, all SAH patients also received conventional carotid angiography. Results: All the sixteen patients, CTA could clearly show the structure of circle of Willis. We found there were (1) absence of PCoA in six patients (2) absence of Al portion of ACA in two patients. (3) hypoplasia of Al in two patients. Of the eight SAH patients, seven were found to have an aneurysm either in the posterior communicating arteries (four patients) or in the anterior communicating arteries (three patients), and one patient had negative findings. The CTA findings in all of the patients were in agreement with conventional carotid angiographic findings. Conclusion: CTA is a good non-invasive modality for the evaluation of the anatomy of circle of Willis and the aneurysms in this circle. |
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