影响颅内支架CT血管成像的相关因素分析  

Analysis of correlative factors affecting the CT angiography imaging of intracranial stents

作　　者：齐羿 张卫国[2] 贾建文[1] 钟红亮[1] 杨洪超 刘赫[1] Qi Yi;Zhang Weiguo;Jia Jianwen;Zhong Hongliang;Yang Hongchao;Liu He(Department of Interventional Neuroradiology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Department of Radiology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院神经介入科,北京100020 [2]首都医科大学附属北京朝阳医院放射科,北京100020

出　　处：《中华解剖与临床杂志》2021年第4期414-418,共5页Chinese Journal of Anatomy and Clinics

摘　　要：目的:探讨影响颅内支架CT血管造影(CTA)成像质量的相关因素。方法:回顾性研究。纳入首都医科大学附属北京朝阳医院2016年7月—2019年10月颅内动脉置入支架、均行CTA及数字减影血管造影(DSA)检查的35例患者的临床资料,其中男28例、女7例,年龄37~83(60.6±7.9)岁,共留置支架35枚。以DSA为金标准,将CTA对支架情况的评估(成像质量)进行分级,并将分级结果与支架部位相关解剖特征(置入部位颅内动脉的直径及其是否紧贴颅骨走行、邻近弹簧圈存在与否)的关系进行统计学分析。结果:以DSA为金标准,CTA的成像质量分级结果的Cohen's Kappa系数为0.826 (95%可信区间为0.638~1.014),一致性好。CTA的成像质量受试者操作特征曲线分析结果显示,血管直径Youden指数为2.505 mm,曲线下面积为0.933;支架所在动脉的解剖部位是否紧贴颅骨走行的两组差异无统计学意义(χ 2=0.282, P>0.05);邻近支架部位是否存在弹簧圈两组差异有统计学意义(χ 2=24.820, P<0.01)。 结论:对于颅内留置支架的患者,当支架所在动脉直径>2.5 mm时,CTA的成像质量较好;颅骨骨质存在对CTA成像无明显影响;弹簧圈的存在会导致CTA成像质量的下降。Objective To investigate the imaging quality of CT angiography(CTA)with intracranial stents.Methods The participants included patients who were enrolled in Beijing Chaoyang Hospital affiliated to Capital Medical University from July 2016 to October 2019 with indwelling stents in the intracranial artery.CTA and digital subtraction angiography(DSA)were used to evaluate the postoperative stent conditions and conduct a retrospective study.The 35 patients consisted of 28 males and 7 females aged 37-83(60.6±7.9)years and included 35 indwelling stents.DSA was used as the standard to classify the evaluation effect(image quality)of CTA on stent condition.A statistical analysis was conducted on the correlation between the grading results and the relevant anatomical features of the stent site(the diameter of the intracranial artery,whether it ran close to the skull,and the presence or absence of coils).Results The Cohen's kappa coefficient of the grading results was 0.826(95%confidence interval 0.638-1.014),which had strong consistency.CTA's role in stent evaluation was closely related to the artery diameter.Analysis of receiver operating curve was performed according to the evaluation quality level.The blood vessel diameter Youden index was 2.505 mm,and the area under the curve(AUC)was 0.933.No statistical difference on whether the anatomical part of the artery where the stent is located is close to the skull was found between the two groups(χ2=0.282,P>0.05).A statistical difference on whether a coil existed adjacent to the stent was observed between the two groups(χ2=24.820,P<0.01).Conclusions For patients with intracranial stents,CTA assessment of the imaging quality is related to the stent diameter.Good imaging quality can be achieved when the diameter of the stent is greater than 2.5 mm.The imaging quality is affected by the presence of the coil but not by the skull.

关 键 词：血管成形 血管支架 血管造影术 数字减影 CT血管造影 弹簧圈 伪影 成像质量 直径 

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