三维CT血管造影与DSA诊断颅内血管瘤的临床价值比较分析  

Clinical diagnosis value of 3d-cta and dsa in intracranial vascular tumors

作　　者：聂中[1] 

机构地区：[1]河南科技大学第一附属医院影像科,河南洛阳471003

出　　处：《现代预防医学》2012年第13期3351-3352,3354,共3页Modern Preventive Medicine

摘　　要：目的比较三维CT血管造影(3D-CTA)与数字减影血管造影(DSA)检查颅内血管瘤的情况,评价3D-CTA与DSA对颅内血管瘤的诊断价值。方法选择2009年2月～2012年2月18例经手术确诊的颅内动脉瘤患者为研究对象,回顾性分析其3D-CTA和DSA检查的影像学资料,比较二者在颅内动脉瘤检查中的特异性、敏感性、准确性以及在动脉瘤细节显示上的优劣性。结果利用3D-CTA共检出动脉瘤21个,其诊断的特异性、敏感性及准确性,大、中动脉瘤均为100.0%,小动脉瘤分别为100.0%、55.8%、90.5%;DSA共检出动脉瘤22个,其诊断的特异性、敏感性及准确性,大动脉瘤均为100.0%,中动脉瘤分别为92.6%、100.0%、98.2%,小动脉瘤分别为100.0%、88.6%、96.6%。两者比较,总的检出率差异无统计学意义(P﹥0.05),但对小动脉瘤的诊断方面3D-CTA不及DSA。而3D-CTA对动脉瘤大小、形态、瘤颈显示、瘤壁钙化及与周围结构的关系等细节显示方面明显优于DSA,差异有统计学意义(P﹤0.05)。结论对于﹥2mm的颅内动脉瘤,3D-CTA可作为颅内动脉瘤检查的首选,但对于≤2mm的动脉瘤的,3D-CTA有一定的局限性。OBJECTIVE To compare the manifestations of three-dimensional computed tomographic angiography（3D-CTA）and digital subtraction angiography（DSA）,to evaluate the diagnosis value of 3D-CTA and DSA in intracranial vascular tumors.METHODS 18 patients with intracranial vascular tumors confirmed by surgery from February 2009 to February 2012 were adopted into the study.The imaging data of 3D-CTA and DSA were retrospectively analyzed to compare the specificity,sensitivity,accuracy and the advantages and disadvantages of showing tumor details.RESULTS 21 intracranial aneurysms were detected by 3D-CTA in 18 patients,with 100% diagnostic specificity,100% sensitivity and 100% accuracy for large and medium aneurysms,and 100.0%,55.8%,90.5% for small aneurysms.22 intracranial aneurysms were detected by DSA in 18 patients,with 100.0% diagnostic specificity,100.0% sensitivity and 100.0% accuracy for large aneurysms,and 92.6%,100.0%,98.2% for medium aneurysms,and 100.0%,88.6%,96.6% for small aneurysms.There was no significant difference in the overall detection rate between 3D-CTA and DSA（P﹥0.05）,but 3D-CTA was less than DSA in the diagnosis of small aneurysm.The 3D-CTA was superior to DSA for aneurysm size,shape,neck show,calcification of aneurysm wall,relationship with surrounding structures and other details show,with statistically significant differences（P﹤0.05）.CONCLUSION For the intracranial aneurysms（≥2 mm）,3D-CTA can be used as the first choice for intracranial aneurysms check,but for the aneurysm（﹤2 mm）,3D-CTA has some limitations.

关 键 词：颅内动脉瘤 血管造影术 体层摄影术 数字减影 

分 类 号：R445.3[医药卫生—影像医学与核医学]