三维旋转血管造影在颅内微小动脉瘤诊断中的应用价值

Effectiveness of Application of 3D-RA in Diagnosis of Intracranial Micro Aneurysms

目的探讨三维旋转血管造影(3D-RA)在颅内微小动脉瘤(直径≤3 mm)诊断中的应用价值。方法对43例颅内微小动脉瘤患者进行常规数字减影血管造影(2D-DSA)及3D-RA检查,分别记录动脉瘤的检出个数、瘤颈显示情况、辐射剂量及对比剂用量。结果 43例患者中,共有48枚微小动脉瘤。2D-DSA检出真阳性微小动脉瘤39枚,假阳性5枚,假阴性9枚,检出率为81%(39/48);3D-RA可将48枚微小动脉瘤全部检出,检出率为100%,检出率的差异具有统计学意义(P<0.05);在动脉瘤瘤颈的显示上,3D-RA较2D-DSA更清晰且差异具有统计学意义(P<0.05);3D-RA检查中对比剂用量及患者接受的辐射剂量均较2D-DSA检查低,且差异均具有统计学意义(P<0.05)。结论与2D-DSA检查相比,3D-RA提高了颅内微小动脉瘤的检出率,且在动脉瘤形态、瘤颈及与载瘤动脉关系的显示等方面优势明显,同时减少了对比剂的用量和患者的辐射剂量。

Objective To evaluate the effectiveness of application of 3D-RA （Three-Dimensional Rotational Angiography） in diagnosis of intracranial micro aneurysms （diameter ≤ 3mm）. Methods Altogether 43 patients with intracranial micro aneurysms were analyzed retrospectively and scanned by both conventional 2D-DSA （Two-Dimensional Digital Subtraction Angiography） and 3D-RA. Then, the detection number of aneurysms, display of the aneurismal neck, radiation dose and contrast agent dosage were recorded respectively. Results Among 43 patients with 48 intracranial micro aneurysms, 39 true micro aneurysms were detected by 2D-DSA, 5 were false positive and 9 were false negative; the detection rate was 81% （39/48）. All the 48 micro aneurysms were detected by 3D-RA, the detection rate of the two methods were significantly different （P〈0.05）. As to the display of the aneurismal neck, 3D-RA was more clear than 2D-DSA, and the difference was significant （P〈0.05）. Compared to 2D-DSA, the contrast dosage and radiation dosage were both lower in 3D-RA examination, and the differences were significant （P〈0.05）. Conclusion 3D-RA had demonstrated its obvious advantages over 2D-DSA in the higher detection rate of micro aneurysms and better display of the morphology of aneurysms, aneurismal necks and their relationship with the parent artery. Meanwhile, it also contributed to the reduced amount of the contrast agent and radiation dose for patients.