The Clinical Value Of CTA In Posterior Communicating Aneurysms Diagnose And Treatment

Objective To discuss the clinical value of 3D-CTA in diagnose and treatment of posterior communicating aneurysms.Methods Collect the CTA information of 50 cases posterior communicating aneurysms which are confirmed by DSA. Then analyse the 3D-CTA image.57 aneurysms are founded,7 non-responsible did not treated by operation which are not include in this research. Measure the distance between the center point of aneurysmal neck and the nearest point of ipsilateral anterior and posterior clinoid and the angle between the major axis of aneurysm and the aneurysmal vertical projection line on horizontal plane, coronal plane and sagittal plane. All 50 cases(50 aneurysms) that treated by operation are divide into two groups. The operations of 17 cases in group A are guided by the preoperative imaging and measurement data under the CTA. Another 33 operations in group B are not guided by the CTA dates, but only the imaging information of CTA. Then two groups are all use trans-frontal lateral approach. Record the aneurysmal direction and rupture proportion of all 50 cases during operation. Then take the CTA review, compare the postoperative rate of aneurysm neck remnant.Results All 50 directions of posterior communicating aneurysms are confirmed by the intraoperative measurement. The rate is 94.00%(47/50); The distance between the center of aneurysmal neck and the nearest point of ipsilateral anterior and posterior clinoid is concentrated in 5-9mm(87.82%) and 4-7mm(94.74%);47 cases(94.00%) posterior communicating artery aneurysm pointing to astern,37 cases(74.00%) pointing inferior; The remnant of in the result of CTA review were no significant different between group A and B(P>0.05);There were also no significant different between group A and B about intraoperative rupture rate(P>0.05).Conclusions 3D-CTA can clearly show the location, direction and the relationship between aneurysm and adjacent anatomical structures. It can make the necessary measurement on CTA reconstruction image; It can provide the necessary measurement based on the CTA reconstructed image which can help surgeon make a treatment plan and prevent intraoperative aneurysm rupture and efficient clip aneurysmal neck.