CT血管造影诊断脑动静脉畸形合并动脉瘤中应用价值研究  

Value of CT angiography in diagnosis of cerebral arteriovenous malformation combined with aneurysms

作　　者：赖志满 谢定祥 胡曼诗 邹梦莎 杨智云[1] 李竹浩[1] LAI Zhi-man;XIE Ding-xiang;HU Man-shi;ZOU Meng-sha;YANG Zhi-yun;LI Zhu-hao(Department of Diagnostic Radiology,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,Guangdong,China)

机构地区：[1]中山大学附属第一医院放射诊断科,广东广州510080

出　　处：《生物医学工程与临床》2021年第2期149-154,共6页Biomedical Engineering and Clinical Medicine

基　　金：广东省科技计划资助项目(201713020229004)。

摘　　要：目的探讨CT血管造影(CTA)对脑动静脉畸形(AVM)合并动脉瘤的诊断价值。方法选择2016年6月至2019年9月中山大学附属第一医院经DSA确诊为AVM合并动脉瘤患者22例,其中男性16例,女性6例;年龄14~59岁,中位年龄43.5岁。行CTA扫描,分别比较DSA与CTA在AVM部位、大小、供血动脉、引流静脉及合并动脉瘤检出情况,以及对分型判别的差异。结果22例患者均诊断为单发AVM,CTA显示畸形团部位与DSA一致;以DSA为"金标准",CTA在诊断AVM合并动脉廇的畸形团最大直径具有很好的一致性;CTA对主要供血动脉及引流静脉准确率分别为91.4%(43/47)、90.3%(65/72),而对合并动脉瘤发现率为87.5%(40/45);根据线性回归分析、组内相关系数分析及Bland-Altman法,均可验证CTA在诊断AVM合并动脉瘤的最大直径、引流动脉分析、引流静脉分析具有良好的一致性。在Redekop分型中,其中Ⅰ型动脉瘤为11/11(100.0%),Ⅱ型和Ⅲ型动脉瘤分别为27/31(87.1%)、2/3(66.7%)。CTA对22例患者AVM分级情况与DSA结果基本一致。结论CTA诊断AVM合并动脉瘤的位置、大小、形态及引流静脉与DSA基本相符,对术前患者手术方案的制定具有良好的指导意义。Objective To study the value of CT angiography(CTA)in diagnosis of arteriovenous malformation(AVM)combined with aneurysms.Methods From June 2016 to September 2019,22 cases of AVM combined with aneurysm diagnosed by digital subtraction angiography(DSA)were enrolled,which included 16 males and 6 females,aged 14-59 years old with median age of 43.5 years old.CTA scan was performed to compare the detection of AVM location,size,feeding artery,drainage vein,combined aneurysm,and the differences in classification between DSA and CTA.Results All of patients were diagnosed as single AVM,CTA scan results showed that the position of malformation was the same as that of DSA test.CTA results showed good consistency with that of DSA,which was the"gold standard",in diagnosis of the maximum diameter of AVM deformities.The accuracy rate of CTA for the main feeding arteries and draining veins were 91.4%(43/47)and 90.3%(65/72),respectively,and the detection rate for combined aneurysms was 87.5%(40/45).It was verified that CTA showed good consistency with DSA in diagnosis of the maximum diameter of AVM combined with aneurysm,drainage artery analysis,and drainage vein analysis by linear regression analysis,intra-group correlation coefficient analysis and Bland-Altman method.In Redekop classification,typeⅠaneurysms were 11/11(100.0%),typeⅡand typeⅢaneurysms were 27/31(87.1%)and 2/3(66.7%),respectively.The AVM classification of 22 patients by CTA was basically consistent with that of DSA.Conclusion It is demonstrated that the location,size,shape and drainage vein of AVM combined with aneurysm by CTA are basically consistent with that of DSA,which will provide good guidance for the formulation of preoperative surgical plans.

关 键 词：脑动静脉畸形(AVM) 动脉瘤 CT血管造影(CTA) 影像诊断 诊断价值 

分 类 号：R743.4[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]