多层螺旋CT血管造影成像在颅脑动脉瘤诊断中的应用及影像特点分析  

Application and imaging characteristics of multi-slice CT angiography in the diagnosis of cerebral aneurysm

作　　者：严吉来[1,2] 杨春 YAN Ji-lai;YANG Chun(Department of Radiology,First Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 210029,China;Jiangsu Provincial Health Development Research Center,Nanjing Jiangsu 210000,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]江苏省卫生健康发展研究中心,江苏南京210000

出　　处：《局解手术学杂志》2025年第3期250-253,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：江苏省卫生健康发展研究中心2023年度开放课题(JSHD202320)。

摘　　要：目的探讨多层螺旋CT血管造影成像(MSCTA)在颅脑动脉瘤(CA)诊断中的应用,并对其影像特点进行分析。方法选取南京医科大学第一附属医院收治的180例疑似CA患者作为研究对象,所有患者依次接受颅脑数字减影血管造影(DSA)、MSCTA检查。以DSA检查结果为金标准,评价MSCTA诊断CA的一致性,对CA分布的诊断符合率、瘤体最大直径及瘤颈最大宽度进行比较。结果180例疑似CA患者,经DSA检查诊断CA 174例,共检出240个动脉瘤;MSCTA检查诊断CA 168例,共检出207个动脉瘤。以DSA检查结果为金标准,MSCTA检查诊断CA的敏感度为96.55%,特异度为100%,准确度为96.67%,Kappa值为0.651,诊断的一致性好。经MSCTA诊断的分布于颈内动脉、椎基底动脉、大脑中动脉、颈内动脉床突、颈内动脉海绵窦段、前交通动脉和后交通动脉的CA符合率分别为81.82%、83.33%、85.71%、87.50%、86.67%、90.00%和90.00%,总体诊断符合率为86.25%。MSCTA与DSA检查所得的瘤体最大直径、瘤颈最大宽度比较,差异均无统计学意义(P>0.05)。结论MSCTA对CA具有较好的诊断价值,与DSA的诊断一致性较高,可在临床推广使用。Objective To explore the application of multi-slice CT angiography(MSCTA)in the diagnosis of cerebral aneurysm(CA),and to analyze its imaging characteristics.Methods A total of 180 patients with suspected CA in the First Affiliated Hospital of Nanjing Medical University were enrolled,and all these patients underwent digital subtraction angiography(DSA)and MSCTA.Taking DSA results as the golden standard,the consistency of MSCTA in the diagnosis of CA was evaluated.The diagnostic coincidence rate of CA distribution,the maximum diameter of tumors and maximum width of tumor neck by the two methods were compared.Results In the 180 patients with suspected CA,DSA showed that there were 174 confirmed cases,including 240 aneurysms,while MSCTA showed that there were 168 confirmed cases,including 207 aneurysms.Taking DSA results as the golden standard,the sensitivity,specificity,accuracy and Kappa value of MSCTA in the diagnosis of CA were 96.55%,100%,96.67%and 0.651 respectively,showing good diagnostic consistency.The diagnostic coincidence rates of CA distributed in the internal carotid artery,vertebrobasilar artery,middle cerebral artery,clinoid process of internal carotid artery,cavernous sinus segment of internal carotid artery,anterior communicating artery and posterior communicating artery diagnosed by MSCTA were 81.82%,83.33%,85.71%,87.50%,86.67%,90.00%and 90.00%,and the overall diagnostic coincidence rate was 86.25%.There was no significant difference in the maximum diameter of tumors or maximum width of tumor neck between MSCTA and DSA(P>0.05).Conclusion The diagnostic value of MSCTA for CA is good,whihc has high diagnostic consistency with DSA and can be widely used in clinic.

关 键 词：颅脑动脉瘤 多层螺旋CT血管造影成像 数字减影血管造影 诊断价值 影像特点 

分 类 号：R739.4[医药卫生—肿瘤]