CTA与DSA在颅内动脉瘤诊断中的对比研究  

Comparative Study of CTA and DSA in the Diagnosis of Intracranial Aneurysms

作　　者：朱君孺 陈宏山[1] ZHU Jun-ru;CHEN Hong-shan(Ct Room,the First People’s Hospital of Huainan,Huainan 232000,Anhui Province,China)

机构地区：[1]淮南市第一人民医院CT室,安徽淮南232000

出　　处：《中国CT和MRI杂志》2022年第5期43-45,共3页Chinese Journal of CT and MRI

摘　　要：目的 分析并对比三维螺旋CT血管成像(3D-CTA)与三维数字减影血管造影(3D-DSA)在颅内动脉瘤(AN)诊断中的诊断效能。方法 回顾性分析72例疑似AN患者,分别采用3D-CTA和3D-DSA检查,对比两种检验方式的检查结果、检查结果一致性、瘤体最大直径与瘤颈径和3D-CTA对确诊的瘤体位置检出准确率。结果 72例疑似AN病例中,经3D-DSA检查后确诊为AN有66例,共检出82个瘤体灶,AN瘤体最大直径为(5.52±2.48)mm,瘤颈径为(3.81±1.18)mm;3D-CTA检查确诊为AN有68例,共检出76个瘤体灶,以3D-DSA检验结果为“金标准”,3D-CTA诊断准确率为95.83%,误诊率为4.17%,漏诊率为8.33%,两种检查方式两种检测方法的一致性分析采用Kappa检验为0.647,一致性较高;3D-CTA与3D-DSA检查瘤体最大直径和瘤颈径对比,差异无统计学意义(P>0.05);3D-CTA检出后交通动脉、大脑中动脉、大脑中动脉、大脑前动脉、小脑后下动脉及椎动脉部位的瘤体检出率均为100.00%,检出前交通动脉、大脑前动脉、大脑后动脉、颈内动脉分别为90.00%、75.00%、66.67%、87.50%。结论 应用3D-CTA检查是一种无创、快速、安全的影像学手段,对于诊断颅内动脉瘤的诊断精确性较高,与3D-DSA检查一致性较高,检查瘤体不同位置的检出率均较高。Objective To compare and analyze the diagnostic efficacy of three-dimensional spiral CT angiography(3D-CTA) and three-dimensional digital subtraction angiography(3D-DSA) in the diagnosis of intracranial aneurysms(AN). Methods A retrospective analysis was performed on 72 patients with suspected AN, and the patients were examined by 3D-CTA and 3D-DSA respectively. The examination results of the two examination methods, the consistency of examination results, the maximum diameter of the tumor and the neck diameter of the tumor, and detection accuracy rate of 3D-CTA on confirmed tumor sites were compared. Results Among 72 cases with suspected AN, 66 cases were diagnosed as AN after 3D-DSA examination, and a total of 82 tumor foci were detected, and the maximum diameter of AN tumor and neck diameter of tumor were(5.52±2.48)mm and(3.81±1.18)mm. 68 cases were diagnosed as AN by 3D-CTA examination, and 76 tumor foci were detected in total. With 3D-DSA examination results as the "gold standard", the diagnosis accuracy rate,misdiagnosis rate and missed diagnosis rate of 3D-CTA were 95.83%, 4.17% and 8.33%. Consistency analysis of the two examination methods showed Kappa value was 0.647, with high consistency.There were no statistically significant differences in the maximum diameter of the tumor and the neck diameter of the tumor between 3D-CTA and 3D-DSA(P>0.05). The detection rates of tumors in posterior communicating artery, middle cerebral artery, anterior cerebral artery, posterior inferior cerebellar artery and vertebral artery by 3D-CTA were all 100.00%, and the detection rates of tumors in anterior communicating artery, anterior cerebral artery, posterior cerebral artery and internal carotid artery were 90.00%, 75.00%, 66.67% and 87.50% respectively. Conclusion 3D-CTA examination is a non-invasive, rapid and safe imaging method. It has high accuracy in the diagnosis of intracranial aneurysms, and has high consistency with 3D-DSA examination, and has high detection rates of tumors in different sites.

关 键 词：颅内动脉瘤 三维血管造影 64排螺旋CT血管成像 CT影像学特征 

分 类 号：R445.3[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]