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

초록

목적: 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 결과: The any aneurysm(s) were not seen in 3D CT angiography in one case. We found the Lt ICA aneurysm at last after consecutive conventional cerebral angiography. Newly found aneurysm(s) that were not seen in 3D CT angiography were reported in 10 cases. The female was dominant (male:female=4:6), the location of the first aneurysm was variable. (MCA 6 cases, ICA 3 cases, and Acom 1case). All the suspected aneurysm at first in 3D CT angiography was verified in operative findings and conventional cerebral angiography. The newly found aneurysm(s) were also variable-but, the location of them were ICA dominant.(ICA 6 cases, MCA 2 cases, Posterior circulation 1 case, and ACA 1 case). In one case, we operated revision because the initial clipping was incomlete and that was confirmed from conventional cerebral angiographic finding. 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 superiority to 3D CT angiography in providing the information of remnant aneurysm(s) of vasospasm.