3D-CTA与3D-DSA诊断颅内动脉瘤的临床对照研究  

Comparison study on 3D-DSA and 3D-CTA contrast in inspection of intracranial aneurysms

作　　者：姚斯元[1] 郭建平[1] 范伊乐 邢鹏毅[1] 张振华[1] 

机构地区：[1]解放军150医院CT室,河南洛阳471003

出　　处：《实用医药杂志》2016年第5期404-406,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的比较三维螺旋CT血管造影(3D-CTA)与数字减影血管造影旋转三维成像(3D-DSA)在颅内动脉瘤诊断中的临床应用价值。方法临床高度怀疑颅内动脉瘤患者53例,均行3D-CTA与3D-DSA检查。CTA图像由2名资深影像医师分别独立判读,DSA图像分剐由1名介入影像医师和1名神经介入医师共同判读。以3DDSA诊断结果为"金标准",对3D-CTA临床诊断效能进行评价。结果 3D-DSA共检出颅内动脉瘤患者44例,病灶51个。3D-CTA共检出颅内动脉瘤患者44例(医师A)或43例(医师B),病灶47个(医师A)或45个(医师B)。以检出病灶教计算,其灵敏度和特异度分别为90.2%(均值)和95.0%(均值)。在大小<3 mm的动脉瘤检出结果中,3DCTA与3D-DSA具有显著性差异(P<0.05)。在瘤体最大直径测量方面,3D-CTA与3D-DSA无显著差异(P>0.05)。结论 3D-CTA对微小动脉瘤(<3mm)漏诊率较高,但总体仍具有较高的临床价值,可作为颅内动脉瘤疑似患者的首选筛查手段。Objective To compare three-dimensional rotational angiography （3D-DSA） with 3D-CT angiography （3D-CTA） in the insptection of intracranial aneurysms. Methods A total of 53 consecutive patients with highly suspected aneurysm were enrolled in this study. All of them underwent both 3D-CTA and 3D-DSA. Two radiologists independently reviewed CT images,and two other radiologists reviewed 3D-DSA images. Using 3D-DSA as the ＂gold standard＂ the clinical diagnostic efficiency of 3D-CTA was evaluated. Results The 3D- DSA revealed 51 aneurysms in 44 patients. The 3D-CTA revealed 47 aneurysms in 44 patients （radiologist A） or 45 aneurysms in 43 patients（radiologist B）. The number of lesions detected,the mean sensitivity and specificity of 3D-CTA for the detection of intracranial aneurysms were 90.2% and 95.0% ,respectively. For aneurysms 〈3 mm, 3D-CTA and 3D-DSA had significant difference （P〈0.05）. For the measurement of aneurysm diameters,the results showed no statistically significant difference （P〉0.05）. Conclusion 3D-CTA has higher rate of missed diagnosis for small artery aneurysm（〈3 mm）,but still has a high clinical value overall,it can be used as the first choice for patients with suspected intracranial aneurysms,yet.

关 键 词：颅内动脉瘤 数字减影血管造影 CT血管成像 

分 类 号：R814.4[医药卫生—影像医学与核医学]