3차원 혈관촬영 CT만으로 진단후 수술한 뇌동맥류 환자에 있어서 수술 후 뇌혈관 조영술의 유용성

초록

적: 3D CT Angiography is now being substituted the conventional cerebral angiography in intracranial aneurysmal subarachnoid hemorrhage. But, the sensitivity and the specificity of 3D CT angiography in comparison to cerebral conventional angiography is controversial yet. We studied the differences of the aneurysmal findings by comparison the preoperative 3D CT angiography and postoperative conventional cerebral angiography 대상: We had operated 125 aneurysmal neck clipping from Oct, 2003 to Mar, 2005. To understand the existence and location of aneurysm(s), we routinely carried 3D CT angiography to all spontaneous SAH patients. We retrospectively analyzed the 99 patients who undergone the aneurysmal clipping in that time. All of them had been taken initial 3D CT angiography without conventional cerebral angiography. Also had performed postoperative conventional cerebral angiography in 2-3 weeks after initial attack. 결론: The use of 3D CT angiography is now increasing in many clinics in its quickness, low dosage of contrast media to conventional angiography, and easily performed in Emergency Room. But the reliability of the 3D CT angiography is decreased in particular, when insufficient blood supply due to high ICP or contrast media mismatching the time when to start the tomography, the absence of cooperation due to patients' consciousness change, or the location of aneurysm is invisible curtained to the bony structure (eq. ICA or posterior circulation). So conventional cerebral angiography is necessary in that its superiorityto 3D CT angiography in providing the information of remnant aneurysm(s) of vasospasm.