157例颅内动脉瘤患者CT血管成像与DSA临床分析  

Comparison of CT Angiography and DSA for Intracranial Aneurysms in 157 Patients

作　　者：陈绵荣 周美娟[1] 林晓汕[3] 纪昌焕[2] 陈志远[2] 吴辉[2] 丁振华[1] 

机构地区：[1]南方医科大学公共卫生与热带医学学院放射医学系,广东广州510515 [2]广州医科大学附属第四医院,广东广州511447 [3]南方医院,广东广州510515

出　　处：《现代生物医学进展》2014年第30期5888-5892,共5页Progress in Modern Biomedicine

基　　金：广州市重大科技专项计划项目(2010U1-E00591-1)

摘　　要：目的:探讨CT血管成像(CTA)在临床诊断颅内动脉瘤的价值。方法:回顾性分析本院157例经影像学检查或手术后确诊为颅内动脉瘤的患者,所有病例均依次行头颅CTA及DSA检查,由A、B两组医生(各三名),对CTA及DSA检查的结果进行独立的双盲判读确定,评估CTA和DSA对颅内动脉瘤诊断的敏感性,特异性;在CTA及DSA图像上分别测得瘤体最长径,比较两种检查在瘤体最长径测量上的结果差异;对颅内微动脉瘤(瘤体直径D<3 mm)检出的敏感性比较。结果:1头颅CTA检出148例(94%),假阴性9例,DSA检出151例(96%),假阴性6例,两者特异性比较,无显著差异(P>0.05)。2在CTA图像上测得瘤体最长径均数D=5.495 mm,在DSA图像上测得瘤体最长径均数D=5.503 mm,两种测量的测量值之间比较,无显著差异(P>0.05)。3在微动脉瘤敏感性上,157例患者共有37个微动脉瘤,CTA检出35个,DSA检出33个,两种检查方法比较,无显著差异(P>0.05)。结论:头颅CTA和DSA在颅内动脉瘤的诊断上具有相同的敏感性和特异性,可作为颅内动脉瘤的首选筛查。Objective： To explore the diagnostic value ofCT angiography （CTA） on intracranial aneurysms. Methods： 157 cases who were diagnosed with intracranial aneurysms by imaging examination or operation were retrospectively reviewed. All cases were examed by head CTA and DSA. CTA and DSA double blind diagnosis were performed by two groups of radiological vice professor （n=3）. In this study, the diagnostic sensitivity and specificity of intracranial aneurysms between CTA and DSA were evaluated; The differences of tumor longest diameter and detection rate of microaneurysm （tumor diameter D〈 3 mm） were compared according to CTA and DSA images. Results： ①148 of 157 cases were positive （94%） examined by skull CTA and 9 cases were false negative, 151 of 157 cases were positive （96%） examined by DSA and 6 cases were false negative, the difference in their specificity was not significant （P〉 0.05）. ②The longest mean diameter of the tumor measured on CTA image was 5.495 mm and that of on the DSA images was 5.503 mm, the difference between two methods was not significant （P〉0.05）. ③ 37 of 157 cases were diagnosed as microaneurysm, 35 cases were positive examined by CTA and 33 cases were positive examined by DSA, the difference between both detection rates of microaneurysm was not significant （P〉0.05）. Conclusion： CTA should be the preferred method in intracranial aneurysms diagnosis since CTA as well as DSA have the same specificity and sensitivity.

关 键 词：颅内动脉瘤 螺旋CT 血管造影 三维数字减影 

分 类 号：R732.21[医药卫生—肿瘤] R814.42[医药卫生—临床医学]