颅内动脉瘤的电子束CT血管造影与DSA对照研究  

Comparative Study of 3D-EBCTA and DSA in Intracranial Aneurysms

作　　者：陈爽[1] 洪泳[1] 沈天真[1] 陈星荣[1] 

机构地区：[1]上海医科大学附属华山医院

出　　处：《中国医学计算机成像杂志》1998年第2期75-79,共5页Chinese Computed Medical Imaging

摘　　要：目的：评价电子束ＣＴ三维血管重建在诊断颅内动脉瘤中的价值与限度。材料和方法：采用ＩｍａｔｒｏｎＣ－１５０型电子束成像系统，对３１例可疑动脉瘤患者进行了ＥＢＣＴＡ和ＤＳＡ对照研究。结果：发现２３例共２４个动脉瘤，包括３例术后随访病人。ＥＢＣＴＡ上发现动脉瘤最小直径为５ｍｍ，最大直径为４１ｍｍ，其中１例ＤＳＡ阴性，而ＣＴＡ阳性，ＥＢＣＴＡ假阳性１例，假阴性２例。ＥＢＣＴＡ诊断动脉瘤的敏感度９２．０％，特异度８８．９％，准确度９１．２％，阳性预测值９５．８％，阴性预测值８０．０％，同时分析了ＥＢＣＴＡ误、漏诊原因。结论：ＥＢＣＴＡ能够明确瘤体的部位、瘤颈、载瘤动脉以及与周围邻近结构的关系，是诊断、筛选动脉瘤以及术后随访的有效手段，在某些方面可以替代甚至超过ＤＳＡ，当病变在ＤＳＡ上不显影时，ＣＴＡ不失为一种补充检查方法。ＭＩＰ和ＳＳＤ两种重建方法各有优缺点，应该相互补充。urpose:To evaluate the value of 3D-EBCTA in diagnosing intracranial aneurysm.Materials and methods:We used Imatron C-150 EBCTA scanner,31 cases of suspected cerebral aneurysms were examined by 3D-EBCTA and DSA.Results:23 cases(24 aneurysms)were found,including postoperative 3 cases.The minimal and maximal diameters of aneurysms shown on 3D-EBCTA were 5mm and 41mm respectively.There were false positive 1 case and false negative 2 cases on 3D-EBCTA,and 1 aneurysm was not revealed on DSA which was positive on 3D-EBCTA.The sensitivity,specifivity,accuracy,positive PV and negative PV in the diagnosis of cerebral aneurysms with 3D-EBCTA were 92.0%,88.9%,91.2%,95.8%,80.0%respectively,and we also analysed the reasons for false positive and false negative results.Conclusion:3D-EBCTA can dertermine the location,shape,parent arteries,necks of aneurysms and their relationship with surrounding structures.3D-EBCTA is a noninvasive,rapid and valuable method in diagnosis,screening for patients with suspected aneurysms and postoperative,the 3D-EBCTA is efficient when aneurysms are not shown on DSA due to spasm or thrombus.The reconstruction modes such as MIP and SSD have their own advantages and disadvantages,they should be used together to optimise the visualization.

关 键 词：颅内动脉瘤 DSA CT 血管造影 

分 类 号：R739.41[医药卫生—肿瘤] R730.44[医药卫生—临床医学]