3D-CTA与3D-DSA在颅内动脉瘤夹闭术后的随访对比  

Comparative study of 3D-CTA and 3D-DSA in the follow up of intracranial aneurysm clipping

作　　者：肖华[1] 姚声涛[1] 李刚[1] 范瑞明[1] 夏湘平[1] 焦松[1] 韩冲[1] 曾尤超[1] 刘锐[1] 唐均[1] 曹芳[1] 吴海涛[2] 孙晓川[3] 

机构地区：[1]遵义医学院附属医院脑血管病科,贵州遵义563099 [2]遵义医学院附属医院神经外科,贵州遵义563099 [3]重庆医科大学附属医院神经外科,重庆400016

出　　处：《遵义医学院学报》2015年第5期501-505,共5页Journal of Zunyi Medical University

基　　金：国家临床重点专科建设项目经费资助(NO:财社[2011]170);贵州省科学技术基金资助项目(NO:黔科合J字[2013]2332)

摘　　要：目的通过与3D-DSA比较,探讨3D-CTA在颅内动脉瘤夹闭术后随访观察疗效中的应用价值。方法选取2011年8月至2013年12月我院神经外科在显微镜下经翼点入路行颅内动脉瘤夹闭术,术后均接受3D-CTA和3D-DSA随访的患者。有41例患者随访,44个夹闭动脉瘤纳入研究。以3D-DSA为参考标准,分别评价3D-CTA检查发现动脉瘤残留、复发,以及载瘤动脉狭窄、闭塞的灵敏性、特异性及阳性、阴性预测率。结果有1例后交通动脉瘤夹闭术后随访患者,3D-CTA及3D-DSA检查均发现动脉瘤残留,未发现动脉瘤复发病。另外有1例后交通动脉瘤夹闭术后随访患者,3D-CTA及3D-DSA检查均发现载瘤动脉闭塞,未发现载瘤动脉狭窄病例。3D-CTA评价动脉瘤残留及载瘤动脉闭塞的敏感性、特异性及阴性、阳性预测率均为100%,准确性与3D-DSA一致。结论随着高分辨率CT的应用及软件技术的发展,3D-CTA能够作为颅内动脉瘤夹闭术后随访观察疗效的常规检查方法。Objective To compare three - dimensional digital subtraction angiography （ 3 D - DSA） with three - dimensional spiral CT angiography （3D -CTA） in follow up observation for curative effect of intracranial aneurysm clipping and their application. Methods 41 cases of intracranial aneurysm postoperative patients （44 aneurysms） of our department microscope clipping line via pterion approach of intracranial aneurysms from August 2011 to December 2013, were enrolled and the patients follow -up were performed by 3D -CTA and 3D -DSA respectively. The residual aneurysm or recurrence, and parent artery stenosis or occlusion of the sensitivity, specificity, and positive and negative predictive value of both 3 D - CTA and 3 D - DSA examination were analyzed. Results One case with residual aneurysms was found by both 3 D - CTA and 3 D - DSA examination Moreover, one case with parent artery occlusion also was found by both examinations. 3 D - CTA and 3 D - DSA showed no recurrence of the aneurysm and parent artery stenosis. 3D -CTA evaluation of residual aneurysm and parent artery occlusion sensitivity, specificity, and negative and positive predictive value was 100%, and accuracy is consistent with 3 D - DSA. Conclusion With the development of high - resolution CT applications and software technology, 3 D - CTA is expected as a routine examination of intracranial aneurysm efficacy of postoperative follow - up.

关 键 词：颅内动脉瘤 三维-螺旋CT血管造影 三维-数字减影血管造影 术后随访 

分 类 号：R651.1[医药卫生—外科学]