摘要
目的评价双源CT血管成像(DSCTA)在颅内动脉瘤诊断中的价值,并与常规和三维旋转DSA进行对照研究。方法95例自发性蛛网膜下腔出血患者同时进行了DSCTA和DSA检查,用2种方法分别评价动脉瘤的检出率、形态、长轴及动脉瘤瘤颈/短轴(N/D)比值。动脉瘤N/D值比较采用配对t检验,长轴比较采用两相关样本的非参数检验。结果95例患者,DSA在63例患者中检出67个动脉瘤,DSCTA在60例患者中检出64个动脉瘤,32例患者未检测到动脉瘤。DSCTA检测动脉瘤总的诊断敏感性、特异性、阳性预测值及阴性预测值分别为94.2%、100.0%、100.0%、91.4%。DSCTA对长径/〉3mm动脉瘤的检出率与DSA一致,其诊断敏感性、特异性均为100%;长径〈3mm动脉瘤的诊断敏感性和特异性分别为80.0%和100.0%:DSA与DSCTA所测动脉瘤N/D比值分别为0.46±0.14、0.51±0.18,差异无统计学意义(t=3.20,P〉0.05);长轴中位数分别为4.9、4.8mm,差异也无统计学意义(Z=-1.309,P〉0.05)。结论DSCTA在诊断颅内动脉瘤方面与常规和三维旋转DSA相比有很高的敏感性和特异性,提高了小动脉瘤的检出率,可作为一种无创性的常规筛查方法。
Objective To assess the value of dual-source computed tomography angiography (DSCTA) in detecting intracranial aneurysms by comparing with conventional and three-dimensional DSA. Methods In this study, 95 patients with subarachnoid hemorrhage (SAH) underwent both DSCTA and DSA examination. The detection rate, size, and ratio of the neck to the dome ( N/D ratio) of the aneurysms were evaluated. Statistical analysis was performed using a paired sample Student's t-test for the comparisons of the value of N/D and 2 Related Samples test for long axis. Results A total of 67 aneurysms in 63 patients at DSA and 64 aneurysms in 60 patients at DSCTA were detected, respectively; whereas no aneurysm was detected in 32 patients at DSA. Compared with DSA, the overall sensitivity, specificity, positive predictive value, and negative predictive value of DSCTA on a per-aneurysm basis were 94. 2%, 100. 0% ,100.0%, and 91.4%, respectively. For the aneurysms larger than 3 mm, the sensitivity and specificity of DSCTA in detecting intracranial aneurysms were equal to those of DSA ; For aneurysms smaller than 3 mm, however, the sensitivity and specificity of DSCTA is 80. 0% and 100.0%. The N/D ratio for DSA and DSCTA was 0.46 ± 0. 14 and 0. 51 ± 0. 18, respectively, and the median of long axis was 4. 9 mm and 4.8 mm, respectively. There was no significant difference in the N/D ratio ( t = 3.20 ; P 〉 0. 05 ) and the long axis ( Z = - 1. 309 ; P 〉 0. 05) between DSA and DSCT. Conclusions Compared with conventional and three-dimensional digital subtraction angiography, DSCTA has high sensitivity and specificity in the detection of intracranial aneurysms, especially for detection of small aneurysms( 〈 3 mm). It can be used as a routine screening technique.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2008年第9期941-944,共4页
Chinese Journal of Radiology
基金
973计划基金项目资助(2006CB705707)