颅内动脉瘤CTA与DSA的影像学特征及诊断价值  

Imaging characteristics and diagnostic value of CTA and DSA in intracranial aneurysm

作　　者：孙伟 刘龙 范兆鹏 郑琪 SUN Wei;LIU Long;FAN Zhaopeng;ZHENG Qi(Huainan Xinhua Medical Group Xinhua Hospital,Huainan 232000,China)

机构地区：[1]淮南新华医疗集团新华医院,安徽淮南232000

出　　处：《中国实用神经疾病杂志》2025年第2期167-171,共5页Chinese Journal of Practical Nervous Diseases

基　　金：2021年度安徽省卫生健康委科研项目(编号:AHWJ2021b137)。

摘　　要：目的探讨颅内动脉瘤(IA)CT血管造影(CTA)与减影血管造影(DSA)影像学特征及诊断价值。方法选取2022-01—2024-03淮南新华医疗集团新华医院收治的82例疑似IA患者为研究对象,均接受CTA和DSA检查,比较影像学特征,并以DSA结果为金标准,分析CTA诊断IA的诊断价值。采用Logistic回归分析构建CTA诊断IA的模型,受试者工作特征(ROC)曲线预测模型的诊断效能。结果以DSA结果为金标准,82例疑似IA患者经DSA及CTA检查确诊36例,CTA诊断IA的敏感度为83.33%,特异度为82.61%,准确度为82.93%,阳性预测值为78.95%,阴性预测值为86.36%,Kappa值为0.655(P<0.05)。经CTA及DSA检查,36例IA患者的动脉瘤瘤长径(H_(max))、瘤垂高度(H_(p))、瘤颈宽度(ND)、瘤体宽度(W)、载瘤动脉直径(Dv)、纵横比(AR)、尺寸比(SR)等影像学特征均有统计学差异(t=2.205、3.387、2.108、2.072、2.000、2.154、2.107,P<0.05)。Logistic回归分析显示,CTA测量Hmax、Hp、AR及SR均对AI具有诊断价值(P<0.05)。建立诊断模型,模型诊断概率P=1[/1+e^(-1.946+0.379×(Hmax)+0.384×(Hp)+0.398×(AR)+0.382×(SR))],模型拟合度Hosmer-Lemeshowχ^(2)=0.834,P=0.116。ROC曲线检验该模型诊断效能显示AUC为0.830(P<0.05)。结论CTA诊断IA具有较高的应用价值,能清晰显示动脉瘤的影像学特征。Objective To investigate imaging characteristics and diagnostic value of CT angiography(CTA)and digital subtraction angiography(DSA)in intracranial aneurysm(IA).Methods A total of 82 patients with suspected IA who underwent CTA and DSA in Huainan Xinhua Medical Group Xinhua Hospital between January 2022 and March 2024 were enrolled as the research objects.The imaging characteristics of CTA and DSA were compared.Taking DSA results as the golden standard,the diagnostic value of CTA in IA was analyzed.CTA diagnosis model for IA was constructed by Logistic regression analysis,and its diagnostic efficiency was tested by receiver operating characteristic(ROC)curves.Results Taking DSA results as the golden standard,in the 82 patients with suspected IA,CTA showed that there were 36 confirmed cases,and its sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa value were 83.33%,82.61%,82.93%,78.95%,86.36%and 0.655,respectively(P<0.05).There were significant differences in long diameter of aneurysm(H_(max)),height(H_(p)),neck width of tumor(ND),width(W),diameter of tumor carrying artery(Dv),aspect ratio(AR)and size ratio(SR)between CTA and DSA(t=2.205,3.387,2.108,2.072,2.000,2.154,2.107,respectively,P<0.05).Logistic regression analysis showed that Hmax,Hp,AR and SR by CTA had diagnostic value for AI(P<0.05).The incidence of AI by the model was as follow:P=1/[1+e^(-1.946+0.379×(Hmax)+0.384×(Hp)+0.398×(AR)+0.382×(SR))],and the model fit by Hosmer-Lemeshow test was as follow:χ^(2)=0.834,P=0.116.ROC curves analysis showed that the AUC of the model in the diagnosis of AI was 0.830(P<0.05).Conclusion CTA has higher application value in the diagnosis of IA,which can clearly display imaging characteristics of aneurysms.

关 键 词：颅内动脉瘤 CT血管造影 减影血管造影 影像学特征 诊断效能 

分 类 号：R739.41[医药卫生—肿瘤]