容积重建成像三维CT血管造影在急性破裂性颅内动脉瘤诊断中的应用研究

Clinical study of three dimensional computerized tomographic angiography with volume reconstruction in the diagnosis of acute ruptured intracranial aneurysms

目的探讨容积重建三维CT血管造影(3D-CTA)技术在急性破裂性颅内动脉瘤诊断中的临床应用价值。方法回顾性总结分析146例164个急性破裂性颅内动脉瘤的容积重建3D-CTA和数字减影造影术(DSA)影像学资料。影像学分析诊断采用双盲法。结果146例患者共发现164个动脉瘤,120例患者为单发动脉瘤,8例为2个动脉瘤,5例为3个动脉瘤。3D-CTA容积重建(VR)漏诊10例,DSA漏诊3例。经统计学分析3D-CTA容积重建在诊断颅内动脉瘤的准确性、敏感性为94.5%、95.0%。结论3D-CTA容积重建技术在急性破裂性颅内动脉瘤的诊断中具有较好的准确性和敏感性,在颅内动脉瘤的诊断中具有重要的筛检价值。

Objective To evaluate the diagnostic value of three -dimensional computerized tomographic angiography （ 3 D - CTA ） and volume reconstruction （ VR ） in acute ruptured intracranial aneurysms. Methods Images of 3D- CTA and digital subtraction angiography （ DSA ） and operative data of 164 aneurysms in 146 cases were reviewed independently by 2 radiologists who didn＇t know the results. Results A total of 164 aneurysms were verified by DSA and surgery in 146 patients. 120 patients had single aneurysm, 8 patients had 2 aneurysms and 5 patients had 3 aneurysms. 10 aneurysms were misdiagnosed with 3D - CTA and 3 aneurysms with DSA. Sensitivity and specificity of 3D - CTA and VR for the diagnosis of intracranial aneurysms were 94.5%, 95.0% respectively. Conclusions 3D - CTA and VR have an important role in screening intracranial aneurysms with considerably high sensitivity and specificity.