三维CT血管成像对颅内动脉瘤的诊断价值  

Diagnostic Value of Three-dimensional CT Angiography in Intracranial Aneurysms

作　　者：刘艺超[1] 修良昌 王超[1] 邱晓晖[1] Liu Yi-chao;XIU Liang-chang;WANG Chao;QIU Xiao-hui(Image Center of Bozhou People's Hospital,Bozhou 236800,Anhui Province,China;Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Medical University,Dongguan 523000,Guangdong Province,China.)

机构地区：[1]亳州市人民医院影像中心,安徽亳州236800 [2]广东医科大学公共卫生学院流行病与卫生统计学系,广东东莞523000

出　　处：《中国CT和MRI杂志》2023年第11期31-33,共3页Chinese Journal of CT and MRI

基　　金：中国红十字基金会科研项目(XMHRYXFN20210524)。

摘　　要：目的探讨三维CT血管造影(3D-CTA)在颅内动脉瘤诊断中的价值。方法回顾分析2020年11月至2022年12月我院以颅内动脉瘤收治并行3D-CTA和3D-DSA检查的患者114例。以3D-DSA为“金标准”,分析3D-CTA对颅脑动脉瘤的诊断效能。结果所有114例患者,经3D-DSA检查7例患者未检出动脉瘤,107例患者检测出139个动脉瘤。3D-CTA未检查出动脉瘤11例,103例患者检测出动脉瘤133个,诊断灵敏度95.32%,特异度85.71%,准确率94.74%,阳性预测值99.03%,阴性预测值54.55%。经3D-CTA诊断的后交通动脉和椎-基底动脉动脉瘤与3D-DSA符合率均为100%,大脑前动脉、大脑中动脉、大脑后动脉、前交通动脉、颈内动脉与3D-DSA诊断的符合率分别为90.91%、95.45%、95.00%、94.74%、94.44%,总符合率为95.68%。3D-CTA和3D-DSA测量瘤颈宽度与瘤体最大径比较差异均无统计学意义。结论当颅脑动脉瘤患者病情危急或无法使用3D-DSA诊断时,3D-CTA可作为3D-DSA替代手段用于颅脑动脉瘤诊断。Objective To explore the value of three-dimensional CT angiography(3D-CTA)in the diagnosis of intracranial aneurysms.Methods A retrospective analysis of the clinical data of 114 patients admitted with an intracranial aneurysm in our hospital from November 2020 to December 2022 was conducted.Using 3D-DSA as the gold standard,the diagnostic efficacy of 3D-CTA in intracranial aneurysms was analyzed.Results Among all 114 patients,7 patients did not detect any aneurysms through 3D-DSA examination,while 107 patients detected 139 aneurysms.No 11 aneurysms were not detected by 3D-CTA,and 133 aneurysms were detected in 103 patients.The diagnostic sensitivity was 95.32%,specificity was 85.71%,accuracy was 94.74%,positive predictive value was 99.03%,and positive predictive value was 54.55%.The coincidence rate of posterior communicating artery and vertebrobasilar artery artery diagnosed by 3D-DSA with DSA was 100%,and the coincidence rate of anterior cerebral artery,middle cerebral artery,posterior cerebral artery,anterior communicating artery,and internal carotid artery with DSA was 90.91%,95.45%,95.00%,94.74%,94.44%,and total is 95.68%,respectively.There was no significant difference between neck width and maximum diameter measured by 3D-CTA and 3D-DSA.Conclusion When patients with cerebral aneurysms are in critical condition or cannot be diagnosed using 3D-DSA,3D-CTA can be used as a substitute for 3D-DSA in the diagnosis of cerebral aneurysms.

关 键 词：颅脑动脉瘤 3D-DSA 3D-CTA 诊断效能 

分 类 号：R651.1[医药卫生—外科学]