64排螺旋CT血管造影与3D-DSA在颅内动脉瘤诊断中的对比研究

Comparative study of 64 rows helical CT angiography and 3D-DSA in diagnosis of intracranial aneurysms

目的探讨64排螺旋CT血管造影(CTA)、三维数字减影血管造影(3D-DSA)在颅内动脉瘤诊断中的应用价值。方法回顾性分析39例颅内动脉瘤患者的64排螺旋CTA、3D-DSA和手术资料,以手术为标准判定CTA和3D-DSA的临床诊断价值。结果 39例患者共发现44个动脉瘤,其中35例为单个动脉瘤,3例为2个动脉瘤,1例为3个动脉瘤。动脉瘤直径最小2.2mm,最大直径27mm。3D-DSA检出动脉瘤44个,与手术结果一致。3D-DSA能清晰显示所有动脉瘤的位置、大小、形态以及瘤颈宽度、瘤顶指向,发现动脉瘤的敏感性、特异性均为100%。64排螺旋CTA检出动脉瘤43个,漏诊1个,假阳性1个,64排螺旋CTA所显示的动脉瘤的位置、大小、形态及与周围结构关系与手术治疗所见一致,对动脉瘤的敏感性、特异性分别为97.7%和97.4%。结论 64排螺旋CTA诊断颅内动脉瘤有较高准确性,绝大部分动脉瘤性蛛网膜下腔出血的患者可以直接依据64排螺旋CTA结果进行手术治疗,在指导动脉瘤治疗方面可对3D-DSA起到重要补充作用。

Objective To investigate the application value of 64 rows helical CT angiography （CTA） and three-dimensional digital subtraction angiography （3D-DSA） in diagnosis of intracranial aneurysms. Methods The clinical data of 39 patients who were suspected of intracranial aneurysms after receiving 64 rows helical CTA and 3D-DSA examination, who received microsurgical operation treatment, were retrospectively analyzed, and the diagnostic value of 64 rows helical CTA and 3D-DSA was evaluated according to the results after operation. Results A total of 44 aneurysms were found among the 39 patients, in which, there were 35 cases of single aneurysm,3 patients had two aneurysms and 1 patient had three aneurysms. The smallest diameter of the aneurysms was 2.2mm and the largest diameter was 27mm. The 3D-DSA discovered 44 aneurysms in 39 patients,which was correspondent with the results after operation. The 3D-DSA could demonstrate the size, shape, neck, axis point of the aneurysms more clearly and it~ sensitivity and specificity in detecting aneuryusms were all 100%. The 64 rows helical CTA discovered 43 aneurysms in 39 patients, 1 aneurysm was missed, and 1 aneurysm was false positive. The 64 rows helical CTA demonstrated the size, shape, neck,axis point of the aneurysms and the three dimensional relationship of aneurysms with parent vessels, which was correspondent with the results after operation, and its sensitivity and specificity were 97.7% and 97.4% respectively. Conclusion The 64 rows helical CTA has higher accuracy in the diagnosis for intracranial aneurysm, and most of the patients with subarachnoid hemorrhage because of aneurysm can be operated directly according to the examination results of 64 rows helical CTA, and 3D-DSA plays an important supplementary effect in directing treatment for intracranial aneurysms.