Multidetector computed tomography angiography for diagnosis of traumatic aneurysms associated with penetrating head injuries  

作　　者：Babichev Konstantin Nickolaevich Savello Aleksandr Viktorovich Isaeva Alla Vladimirovna Svistov Dmitrij Vladimirovich Men'kov Igor'Anatol'evich Isaev Dzhamaludin Magomedrasulovich 

机构地区：[1]Department of Neurosurgery,Military Medical Academy n.a.S.M.Kirov,194044,St.Petersburg,Russia [2]Department of Radiology,Military Medical Academy n.a.S.M.Kirov,194044,St.Petersburg,Russia

出　　处：《Chinese Journal of Traumatology》2025年第2期91-95,共5页中华创伤杂志(英文版)

摘　　要：Purpose:To analyze the diagnostic efficacy of computed tomography angiography compared to digital cerebral angiography for the diagnosis of traumatic aneurysms(TAs)associated with combat-related penetrating head injuries and propose the most suitable angiography protocol in this clinical context.Methods:A retrospective analysis was conducted on patients admitted to the neurosurgical clinic for penetrating traumatic brain injuries between February,2022 and July,2024,for whom both cerebral multidetector computed tomography angiography(MCTA)and digital cerebral angiography(DCA)were available.The inclusion were patients(1)with penetrating head injuries,(2)with missile trajectory traverses through the Sylvian or great longitudinal fissure,(3)basal cisterns with/or major subarachnoid hemorrhage.The sensitivity,specificity,positive predictive value,and negative predictive value of MCTA were calculated.DCA was considered as the gold standard of diagnosis.The sensitivity,specificity,positive predictive value,and negative predictive value of MCTA were calculated.Descriptive statistics and nonparametric statistics were used to analyze the study results and their differences,respectively.Results:A total of 40 patients with 45 TAs were included in the study.Of these,26 patients(65.0%)were found to have aneurysms on MCTA.The median diameter of the aneurysms diagnosed by MCTA was 4.9(3.6,4.8)mm(range of 2.5-10.4 mm).However,the mean diameter of TAs not detected by MCTA but diagnosed by DCA was(3.0±1.3)mm(range of 1.3-4.9 mm).MCTA demonstrated sensitivity and specificity of 35.5% and 99.5%,respectively,with positive and negative predictive values of 92.3% and 90.7%.Conclusions:A low sensitivity of MCTA for the diagnosis of TAs associated with combat-related penetrating head injuries was reported.When MCTA is inconclusive in the setting of radiologic predictors of cerebral artery injury,DSA may be required.

关 键 词：Traumatic aneurysm Multidetector computed tomography angiography Digital cerebral angiography Penetrating injury 

分 类 号：R651.1[医药卫生—外科学]