3D-CTA诊断颅内动脉瘤破裂的准确率及对患者预后预测效能研究  

Accuracy of 3D-CTA in diagnosis of ruptured intracranial aneurysm and prognosis prediction

作　　者：徐淑玲 朱阳 丁莉 Xu Shuling;Zhu Yang;Ding Li(Wuxi People's Hospital,Wuxi,Jiangsu 214000,China)

机构地区：[1]江苏省无锡市人民医院,江苏无锡214000

出　　处：《首都食品与医药》2023年第22期77-80,共4页Capital Food Medicine

摘　　要：目的分析三维CT血管造影(3D-CTA)诊断颅内动脉瘤破裂的准确率及对患者预后预测效能。方法选定无锡市人民医院2021年2月-2023年2月就诊的102例高度疑似颅内动脉瘤破裂患者展开研究,均给予3D-CTA检查,将三维数字减影血管造影(3D-DSA)作为诊断金标准,统计3D-CTA诊断准确率、灵敏度、特异度,Kappa检验3D-CTA与3D-DSA的一致性。比较3D-CTA、3D-DSA诊断下瘤颈最大径、瘤体最大径及影像学显示能力,绘制受试者工作曲线(ROC),分析3D-CTA对颅内动脉瘤破裂患者预后不良的预测效能。结果3D-DSA确诊91例颅内动脉瘤破裂,3D-CTA确诊89例颅内动脉瘤破裂,3D-CTA诊断准确率是97.06%,灵敏度是97.80%,特异度是90.91%,Kappa检验3D-CTA与3D-DSA的一致性较好(Kappa值=0.782)。3D-CTA诊断下瘤颈最大径、瘤体最大径与3D-DSA比较,差异不显著,P>0.05。3D-CTA对瘤颈形态(87.91%)、瘤颈宽度(90.11%)、瘤颈与载瘤动脉关系(86.81%)的显示率与3D-DSA(92.31%、91.21%、89.01%)比较,差异不显著,P>0.05。3D-CTA预测颅内动脉瘤破裂患者预后不良的AUC是0.861,95%CI可信区间是0.825-0.957,灵敏度是94.82%,特异度是90.46%。结论3D-CTA可提高对颅内动脉瘤破裂的诊断准确率,诊断结果与3D-DSA无明显差异,且3D-CTA在预测颅内动脉瘤破裂患者预后方面具有较高的诊断效能,值得参考。Objective To analyze the accuracy of three-dimensional CT angiography(3D-CTA)in the diagnosis of ruptured intracranial aneurysms and its prognostic efficacy.Methods A total of 102 patients with highly suspected ruptured intracranial aneurysms treated in Wuxi People's Hospital from February 2021 to February 2023 were selected for the study.All of them were given 3D-CTA examination.Three-dimensional digital subtraction angiography(3D-DSA)was used as the diagnostic gold standard to analyze the diagnostic accuracy,sensitivity and specificity of 3D-CTA.Kappa tested the consistency of 3D-CTA and 3D-DSA.Compared with 3D-CTA and 3D-DSA,the maximum diameter of tumor neck,the maximum diameter of tumor body and the imaging ability were compared,and receiver operating curve(ROC)was drawn to analyze the predictive efficacy of 3D-CTA in predicting the poor prognosis of patients with ruptured intracranial aneurysms.Result 3D-DSA confirmed 91 cases of intracranial aneurysm rupture,and 3D-CTA confirmed 89 cases of intracranial aneurysm rupture.The diagnostic accuracy of 3D-CTA was 97.06%,the sensitivity was 97.80%,and the specificity was 90.91%.The consistency between 3D-CTA and 3D-DSA was good(Kappa value=0.782).3D-DSA comparison of the maximum diameter of tumor neck and tumor body under 3D-CTA diagnosis,P>0.05.The display rate of 3D-CTA for tumor neck shape(87.91%),tumor neck width(90.11%),and the relationship between tumor neck and carrier artery(86.81%)was compared with that of 3D-DSA(92.31%,91.21%,89.01%),P>0.05.The AUC of 3D-CTA in predicting poor prognosis of patients with ruptured intracranial aneurysms was 0.861,95%CI confidence interval was 0.825-0.957,sensitivity was 94.82%,and specificity was 90.46%.Conclusion 3D-CTA can improve the diagnostic accuracy of ruptured intracranial aneurysm,and there is no significant difference between the diagnostic results and 3D-DSA,and 3D-CTA has high diagnostic efficacy in predicting the prognosis of patients with ruptured intracranial aneurysm,which is worthy of reference.

关 键 词：三维CT血管造影 颅内动脉瘤破裂 诊断效能 预后 

分 类 号：R739.41[医药卫生—肿瘤]