CTA与MRA在诊断颅内动脉瘤中的临床应用价值对比研究  

CTA and MRA in the diagnosis of intracranial aneurysms: a comparative study

作　　者：陈冠亚 祁冬[1] 乔晓春[1] 胡淑敏[1] 田欧[1] 沈艳 CHEN Guan-ya;QI Dong;QIAO Xiao-chun(Department of Medical Imaging,First People's Hospital of Bengbu City,Bengbu 233000,China)

机构地区：[1]蚌埠市第一人民医院医学影像科,安徽蚌埠233000

出　　处：《吉林医学》2021年第12期2853-2856,共4页Jilin Medical Journal

摘　　要：目的:探讨CTA与MRA在诊断颅内动脉瘤中的临床应用价值。方法:回顾性收集2019年~2020年蚌埠市第一人民医院收治的60例疑似动脉瘤破裂蛛网膜下腔出血患者作为研究对象,所有患者均行头部CTA、MRA及DSA检查,以DSA检查结果作为诊断“金标准”,评估两种检查方式在检测颅内动脉瘤中的诊断效能,并对检查结果的一致性行Kappa检验。结果:疑似60例动脉瘤患者中,经DSA证实动脉瘤患者共52例,其中CTA共检测出动脉瘤患者50例,检出率为96.15%,MRA共检测出动脉瘤41例,检出率为78.85%,二者差异有统计学意义(P<0.05)。在检测动脉瘤的敏感性、特异性及准确率方面,CTA分别为94.23%、87.50%及93.33%,均高于MRA检查的73.08%、62.50%及71.67%,差异均有统计学意义(P<0.05);且CTA与DSA检测结果一致性很好(Kappa=0.883),而MRA与DSA检测结果一致性中等(Kappa=0.526)。另外,CTA与MRA在巨大动脉瘤、大动脉瘤和中等动脉瘤检出率差异均无统计学意义(P>0.05),在小动脉瘤和微小动脉瘤检出率差异均有统计学意义(P<0.05),而CTA与DSA在小动脉瘤及微小动脉瘤检出率差异均无统计学意义(P>0.05)。CTA与MRA在瘤颈直径、瘤体长径及短径测量结果比较,差异均无统计学意义(P>0.05)。结论:CTA与MRA在诊断颅内动脉瘤中均具有较高的价值,但CTA检测的敏感性、特异性及检出率高于MRA,特别是对于小动脉瘤和微小动脉瘤的检出率显著高于MRA,与DSA检测结果一致性较高,可作为检测颅内动脉瘤的首选影像学检查方法。Objective To explore the clinical value of CTA and MRA in the diagnosis of intracranial aneurysms.Method Retrospectively collected 60 patients with suspected aneurysmal subarachnoid hemorrhage from January 2019 to December 2020,the head CTA、MRA and DSA examination were performed in all patients.The results of DSA examination were used as the diagnostic"gold standard"to evaluate the diagnostic efficacy of the two methods in the detection of intracranial aneurysms,and the consistent Kappa of the results were tested.Results Of the 60 suspected aneurysms,A total of 52 patients with DSA confirmed aneurysms,Among them CTA 50 patients with aneurysm,The detection rate was 96.15%,A total of 41 cases of aneurysm were detected in MRA,The detection rate was 78.85%,The differences were statistically significant(P<0.05).The sensitivity,specificity and accuracy of CTA in detecting aneurysms were 94.23%,87.50%and 93.33%respectively,which were higher than those of MRA in 73.08%,62.50%and 71.67%,the difference was statistically significant(P<0.05),and the CTA and DSA were in good agreement(Kappa=0.883),while the results of MRA and DSA were moderate(Kappa=0.526).There was no significant difference in the detection rate of giant aneurysm,large aneurysm and medium aneurysm between CTA and MRA(P>0.05),and significant difference in the detection rate of aneurysms and microaneurysms(P<0.05).There was no significant difference between CTA and MRA in the measurement of neck diameter,length and short diameter(P>0.05).Conclusion CTA and MRA have higher value in diagnosing intracranial aneurysms,but the sensitivity,specificity and detection rate of CTA detection are higher than that of small aneurysms and microanterms MRA,especially for small aneurysms,which is consistent with the results of intracranial aneurysms.It can be used as the first imaging method to detect intracranial aneurysms.

关 键 词：CTA MRA 颅内动脉瘤 诊断效能 

分 类 号：R743.4[医药卫生—神经病学与精神病学]