多层螺旋CT血管造影与DSA诊断颅内动脉瘤的效果比较

Detection of intracranial aneurysms:multislice computed tomographic angiography compared with DSA

目的:通过与数字减影血管造影(DSA)和外科手术结果对比,评价16层螺旋CT血管造影(CTA)对颅内动脉瘤诊断的准确性。方法:对356例临床怀疑颅内动脉瘤患者的16层螺旋CTA图像与DSA和外科手术结果进行回顾性对比研究。结果:结合CTA、DSA和术中所见,在356例患者中的195例患者颅内发现215个动脉瘤。5个动脉瘤CTA漏诊,9个动脉瘤在DSA检查中未能清楚显示,但被CTA发现,其中5个得到手术证实,另外4个未行手术治疗。16层螺旋CTA对于动脉瘤检出的敏感性与DSA的结果差别没有统计学意义。结论:16层螺旋CTA对于颅内动脉瘤检出具有很高的敏感性、特异性和准确性,在颅内动脉瘤的筛选、诊断和治疗方案的制定方面可以替代常规DSA检查。

Objective：To assess the diagnostic accuracy of 16-slice computed tomographic angiography （CTA） in detecting intracranial aneurysms compared with digital subtraction angiography（DSA） and surgical findings. Methods：356 cases with suspected intracranial aneurysms received CT scan,and the results were compared to DSA and intraoperative findings retrospectively. Results： Combining CTA,DSA and intraoperative findings,215 aneurysms were detected in 195 of the 356 patients. Five aneurysms were missed when using CTA. Nine aneurysms detected by CTA were not clearly displayed at DSA,five were proved at surgery and four were not performed by surgical treatment. There was no significant difference in sensitivity between 16-slice CTA and DSA. Conclusion： 16- slice CTA has a very high sensitivity,specificity,and accuracy of detecting aneurysms, and it is sensitive enough to replace conventional DSA in the triage, diagnosis, and treatment planning in patients with intracranial aneurysms.