三维多层螺旋CT血管成像对颅内动静脉畸形的诊断价值

The Value of 3D-MSCTA for Diagnosing Intracranial Arteriovenous Malformations

目的探讨三维多层螺旋CT血管成像(3D-MSCTA)对颅内动静脉畸形(AVM)的诊断价值。资料与方法对33例同时行3D-MSCTA和数字减影血管造影(DSA)检查的脑AVM患者的影像资料进行回顾性分析,以DSA为金标准,评价3D-MSCTA诊断准确性,评价指标包括病灶检出率、供血动脉和引流静脉的显示,畸形血管团的部位、形态、大小以及脑内合并病灶。结果 33例患者,3D-MSCTA检出32例35个AVM,1例未检出AVM;DSA检出33例36个AVM,3D-MSCTA检测AVM总的诊断敏感性为96.9%,假阴性率为3.1%。3D-MSCTA在显示AVM血管团、供血动脉及引流静脉方面与DSA没有显著性差异,诊断基本一致;3D-MSCTA同时显示24例DSA无法显示的脑出血。结论 3D-MSCTA是一种基本可以替代DSA作为诊断颅内AVM的无创性的常规筛查方法。

Objective To investigate the role of 3D-MSCTA in the diagnosis of intracranial arteriovenous malformations.Materials and Methods 3D-MSCTA and DSA imaging data of 33 patients with AVM were analyzed restrospectively,diagnostic accuracy of 3D-MSCTA was evaluated with the gold standard of DSA,and estimation targets included lesion detection rate,the display of feeding artery and draining vein and position,shape,size of nidus and intracranial merging lesions.Results Of 33 patients,3D-MSCTA showed 35 AVM in 32 cases except one case,while DSA showed 36 AVM in 33 cases.The sensitivity and false negative rate of 3D-MSCTA for diagnosing AVM were 96.9% and 3.1% respectively.There was no significant difference in depicting nidus,feeding artery and draining vein between 3D-MSCTA and DSA.The 3D-MSCTA could find simultaneously cerebral hemorrhage that were not depicted by DSA in 24 cases.Conclusion 3D-MSCTA can be used as a non-invasive and routine imaging screening method replacing DSA for diagnosing intracranial arteriovenous malformations.