磁共振血管造影与数字减影血管造影在颅内动脉瘤术后检查中的价值比较

Comparison of MRA and DSA in examination after intracranial aneurysm surgery

目的探讨磁共振血管造影(MRA)和数字减影血管造影(DSA)两种技术对颅内动脉瘤术后分级的临床价值。方法对72例颅内动脉瘤术后患者使用DSA和MRA技术检测颅内动脉瘤术后及随访3个月的分级情况,并对比检查结果。结果DSA与TOF-MRA对颅内动脉瘤随访3个月分级的比较差异无统计学意义(χ2=0.95,P>0.05);MRA和DSA检测术后颅内动脉瘤1级的灵敏度分别为94.3%、97.1%,特异度分别为91.9%、89.2%,两种方法检测差异无统计学意义(P>0.05);术后随访颅内动脉瘤分级的增加随高血压的发生率而增加(χ2=7.82,P<0.05),与高血压成正相关(r=0.47,P<0.05);MRA和DSA检测术后颅内动脉瘤患者脑血管平均分支数差异无统计学意义(P>0.05)。结论 MRA与DSA均可应用于随访术后颅内动脉瘤残留瘤的分级,MRA还有无创性检查的优势,值得临床推广。

Objective To compare the clinical value of digital subtraction angiography （DSA） and magnetic resonance angiography （MRA） in grading intracranial aneurysm postoperation. Methods The study recruited 72 patients after surgery for intracranial aneurysm. The grading of intracranial aneurysm postoperation and follow-up for three months was performed by DSA and MRA. Results Grading by DSA and TOF-MRA of intracranial aneurysm after follow-up for three months did not differ significantly （ Х^2 = 0.95, P〉 0.05）. The sensitivity of Class I intracranial aneurysm postoperation detected by MRA and DSA was 94.3% and 97.1% while the specificity was 91. 9% and 89. 2%, respectively, without significant difference （P〉 0. 05）. The grading of intracranial aneurysm postoperation and follow-up increased with the incidence of high blood pressure （ 2 = 7.82, P〈0.05）, showing a positive correlation （r ： 0.47, P~ 0.05）. MRA and DSA did not differ significantly in detecting the average number of cerebrovascular branches in patients with intracranial aneurysm （P〉0.05）. Conclusion MRA and DSA can be used in follow-up of intracranial aneurysm surgery. The former is a non-invasive means of examination, thus deserving wide clinical application.