CT及磁共振血管成像诊断颅内动脉瘤的价值  

Value of computed tomography and magnetic resonance angiography in diagnosing intracranial aneurysms

作　　者：覃星悦[1] 陈圣昌 秦柱贵 陈奎[1] TAN Xingyue;CHEN Shengchang;QIN Zhugui;CHEN Kui(Department of Neurology,Guigang People's Hospital,Guigang 537100,China)

机构地区：[1]广西贵港市人民医院神经内科,广西贵港537100

出　　处：《长春中医药大学学报》2024年第5期566-570,共5页Journal of Changchun University of Chinese Medicine

基　　金：广西省医学科研基金项目(B2021186)。

摘　　要：目的分析CT血管成像(computed tomography angiography,CTA)、磁共振血管成像(magnetic resonance angiography,MRA)诊断颅内动脉瘤的价值。方法选取2020年6月-2023年1月广西贵港市人民医院90例疑似颅内动脉瘤患者,均接受CAT及MRA检查,将数字减影血管成像(digital subtraction angiography,DSA)或手术病理学检查结果作为金标准,比较两种方法检出情况、测量颅内动脉瘤瘤体直径与瘤颈宽度、对比不同大小的颅内动脉瘤检出情况,分析两种方法单独及联合诊断颅内动脉瘤的价值。结果90例疑似颅内动脉瘤患者经CTA检查后诊出64例单发颅内动脉瘤,经MRA检查后诊出61例单发颅内动脉瘤,两种方法检出情况比较无明显差异(P>0.05);当瘤体<3 mm时CTA检出率93.33%高于MRA 60.00%(P<0.05);CTA诊断颅内动脉瘤的准确率83.33%、敏感度83.56%、特异度82.35%、Kappa值=0.548;MRA诊断颅内动脉瘤的准确率82.22%、敏感度80.82%、特异度88.24%、Kappa值=0.543;CTA联合MRA诊断颅内动脉瘤的准确率95.56%、敏感度95.89%、特异度94.12%、Kappa值=0.861。结论CTA与MRA均可用于诊断颅内动脉瘤,其中CTA可明显提高<3 mm的微小颅内动脉瘤诊出率,但联合应用时的敏感度更高。Objective To analyze the value of computed tomography angiography(CTA)and magnetic resonance angiography(MRA)in the diagnosis of intracranial aneurysms.Methods 90 patients with suspected intracranial aneurysms admitted to Guigang People's Hospital from June 2020 to January 2023 were selected.All patients underwent CTA and MRA examinations.The results of digital subtraction angiography(DSA)or surgical pathologic examination were used as the gold standard.The detection results of two methods were compared,the diameter and neck width of intracranial aneurysm were measured,and the detection results of intracranial aneurysms of different sizes were compared.The values of using one of these two methods to diagnose intracranial aneurysms and the combination of these two methods for diagnosing the disease were analyzed.Results After CTA examination,64 patients with single intracranial aneurysms from 90 patients with suspected intracranial aneurysm were diagnosed;And after MRA examination,61 patients were diagnosed with single intracranial aneurysms.There was no statiscally significant difference in the detection results between two methods(P>0.05).When the tumor size was less than 3 mm,the detection rate of CTA was 93.33%,which was higher than 60.00%of MRA(P<0.05);The accuracy,sensitivity,specificity and Kappa value of CTA in the diagnosis of intracranial aneurysms were 83.33%,83.56%,82.35%and 0.548,respectively.The accuracy,sensitivity,specificity and Kappa value of MRA in the diagnosis of intracranial aneurysms were 82.22%,80.82%,88.24%and 0.543,respectively.The accuracy,sensitivity,specificity and Kappa value of CTA combined with MRA in the diagnosis of intracranial aneurysms were 95.56%,95.89%,94.12%and 0.861,respectively.Conclusion CTA and MRA can be used in the diagnosis of intracranial aneurysms,among which the CTA can significantly improve the diagnostic rate of small intracranial aneurysms smaller than 3 mm,but the sensitivity is higher when the two are combined.

关 键 词：64排螺旋CT血管成像 1.5T磁共振血管成像 颅内动脉瘤 诊断效能 数字减影血管成像 

分 类 号：R743.4[医药卫生—神经病学与精神病学]