320排CT血管造影对颅内微小动脉瘤检出能力的初步探讨

Preliminary research on 320-row multisection CT angiography in detecting intracranial microaneurysms

目的初步探讨320排CT三维血管造影(3D-CTA)对颅内微小动脉瘤(<3 mm)的检出能力。方法共59例患者于起病3 d内完成320排CTA检查,并随后行数字减影血管造影(DSA)检查或手术治疗。以DSA结果及术中所见为标准,计算320排3D-CTA对颅内微小动脉瘤的检出率,并研究320排CTA对其检出的动脉瘤判断为微小动脉瘤的准确性。结果 320排CTA共检出颅内动脉瘤47个,对微小动脉瘤和较大动脉瘤(≥3 mm)的检出率分别为86.7%和93.8%,两组检出率无显著性差异(P>0.05)。同时,320排CTA能够将检出的动脉瘤准确测量并判定为微小动脉瘤(敏感性84.6%,特异性96.7%,准确性93.0%)。结论 320排CTA对颅内动脉瘤诊断效能较高,能够准确检出既往诊断困难的颅内微小动脉瘤。320排CTA或能成为诊治颅内动脉瘤的首选检查。

Objective The aim of this study was to explore the diagnostic performance of 320-row muhisection CT angiography （320 MSCTA ）in detecting intracranial microaneurysms （〈 3 mm ）. Methods We studied 59 consecutively admitted patients that received surgery and/or DSA after undergoing 320 MSCTA within 72 hours of onset. With DSA and surgical findings as standard of reference, the sensitivity of 320 MSCTA in detecting mieroaneurysms was investigated, as well as the accuracy in determining microaneurysms. Results A total of 47 aneurysms were detected. The sensitivities for microaneurysms and larger aneurysms（ t〉3 ram）were 86. 7% and 93.8% respectively ,without significant difference between them （P 〉 0. 05 ）. In addition, 320 MSCTA could measure and determine microaneurysms accurately, the sensitivity, specificity, accuracy were 84. 6% , 96. 7% , 93.0% , respectively. Conclusion 320 MSCTA has an outstanding diagnostic performance on intraeranial aneurysms, and can detect microaneurysms accurately, which are difficult to diagnose before. 320 MSCTA may be the preferred examination for intracranial aneurysms in the near future.