CTA对蛛网膜下腔出血并DSA阴性患者诊断价值的研究  

Diagnostic accuracy of computed tomography angiography in patients with catheter angiography-negative subarachnoid hemorrhage

作　　者：李敏[1] 丁娟[1] 翟继良[1] 孙钢[1] 

机构地区：[1]济南军区总医院医学影像科,山东济南250031

出　　处：《医学影像学杂志》2012年第12期1967-1970,共4页Journal of Medical Imaging

摘　　要：目的探讨CT脑血管造影(CTA)对蛛网膜下腔出血(Subarachnoid hemorrhage,SAH)且首次DSA阴性患者再次血管成像的诊断准确性。方法对56例SAH且DSA检查为阴性患者行CTA及DSA成像。以DSA结果为金标准,计算CTA诊断动脉瘤的敏感度、特异度、阳性预测值(PPV)和阴性预测值(NPV)。结果 7例与SAH相关动脉瘤中,CTA发现5例。49例DSA无阳性结果患者中,CTA均无阳性结果。以DSA为金标准,CTA诊断颅内动脉瘤的敏感度为71.43%(95CI,35.89～91.78),特异度为100%(95CI,92.73～100),PPV100%(95CI,56.55～100),NPV96.08%(95CI,86.78～98.92)。结论 CTA作为一种无创性检查手段,可准确地诊断首次DSA阴性SAH患者动脉瘤的存在。未来需要大样本研究证明CTA在临床诊疗过程中的有效性及安全性。Objective To evaluate the accuracy of computed tomography angiography （CTA） to diagnose cerebral aneu- rysms in patients with hemorrhage （SAH） and a negative initial catheter angiogram. Methods 56 patients with SAH and a negative initial catheter angiogram underwent CTA and DSA. With DSA as reference standard, the sensitivity, specifici- ty, positive predictive value （PPV） and negative predictive value （NPV） were calculated. Results Among 7 aneurysms, 5 aneurysms were detected by CTA among 49 patients without aneurysms, no positive symptom was found by CTA. The accuracy of CTA was as followed： sensitivity： 71.43%（95CI, 35.89~91.78）, specificity： 100%（95CI, 92. 73~100）, PPV： 100^（95CI, 56.55^100）, NPV： 96.08%（95CI, 86.78-98.92）. Conclusion CTA is a valuable tool to evaluate patients with SAH and a negative initial catheter angiogram, whose efficiency and safety, however, should be proven by large sample study in the future.

关 键 词：蛛网膜下腔出血 体层摄影术 X线计算机 

分 类 号：R743[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]