3D-CTA、2D-DSA及3D-DSA对颅内动脉瘤诊断价值的对比研究  

Comparative Study of 3D-CTA,2D-DSA and 3D-DSA in the Diagnosis of Intracranial Aneurysms

作　　者：郭建新[1] 冒平[2] 牛刚[1] 赵婷婷[1] 丁辉[1] 王茂德[2] 杨健[1] 

机构地区：[1]西安交通大学医学院第一附属医院影像科,陕西西安710061 [2]西安交通大学医学院第一附属医院神经外科,陕西西安710061

出　　处：《中国CT和MRI杂志》2011年第5期21-23,38,共4页Chinese Journal of CT and MRI

基　　金：国家自然基金(NO:30970797)

摘　　要：目的对比分析64排3D-CTA、2D-DSA及3D-DSA对颅内动脉瘤的影像学诊断价值。方法筛选31例疑似颅内动脉瘤破裂所致的蛛网膜下腔出血病例进行回顾性研究,收集完整的3D-CTA、2D-DSA、3D-DSA及手术资料。比较3D-CTA、2D-DSA、3D-DSA对颅内动脉瘤检查的灵敏度与特异度及其对颅内动脉瘤形态及瘤颈的显示情况。结果 31例蛛网膜下腔出血患者经3D-DSA共检出35枚颅内动脉瘤,3D-CTA及2D-DSA均检出34枚颅内动脉瘤。3D-CTA检查动脉瘤的灵敏度为97.06%,特异度为88.89%。三种检查手段的ROC曲线及其曲线下面积显示3D-CTA与3D-DSA的灵敏度与特异度无显著性差异,但明显高于2D-DSA。3D-DSA及3D-CTA均能良好显示检出动脉瘤的几何形态及动脉瘤瘤颈情况,效果明显优于2D-DSA(P<0.05)。结论利用3D-CTA可安全、有效地检查颅内动脉瘤,其检查效果优于2D-DSA,可作为颅内动脉瘤检查及随访的首选影像学手段。对于临床高度怀疑颅内动脉瘤且3D-CTA阴性的患者,可推荐进一步行3D-DSA检查。Objective To compare and analysis the diagnosis value of three-dimensional computed tomographic angiography（3D-CTA）,conventional digital subtraction angiography（2D-DSA） and three-dimensional digital subtraction angiography（3D-DSA）.Methods 31 patients of subarachnoid hemorrhage who were highly suspected with intracranial aneurysms were chosen for a retrospective study.The data of 3D-CTA,2D-DSA,3D-DSA and operation were totally reviewed.The sensitivity and specificity in intracranial aneurysm detection and aneurysm geometry configuration were compared among 3D-CTA,2D-DSA and 3D-DSA.Results 35 intracranial aneurysms were detected by 3D-DSA in 31 suspicious patients.34 intracranial aneurysms were detected by 3D-CTA and 2D-DSA.The sensitivity and specificity of aneurysms detection of 3D-CTA were 97.06% and 88.89% respectively,which showed no obvious difference compared with those of 3D-DSA from their ROC curves and area under the curves but were higher than those of 2D-DSA.Comparing with 2D-DSA,aneurysm geometry configuration and their necks were also better showed in 3D-DSA and 3D-CTA（P0.05）.Conclusions It is not only safe but also effective for 3D-CTA to detect intracranial aneurysms,which seems to be a better choice for aneurysm detection than that of 2D-DSA.3D-CTA may be first choice for the dection of intracranial aneurysms in clinical diagnosis and follow-up visit.Addtionally,3D-DSA will be suggested for those patients who were highly suspected with intracranial aneurysms but show no positive 3D-CTA result.

关 键 词：颅内动脉瘤 CT血管成像 数字减影血管造影 

分 类 号：R445.2[医药卫生—影像医学与核医学] R73[医药卫生—诊断学]