CTA与DSA在颅内动脉瘤诊断及手术评估中的临床比较研究

Clinical comparative study on CTA and DSA in diagnosis and operative evaluation of intracranial aneurysm

目的探讨CTA与DSA在颅内动脉瘤诊治过程中各自的优势,为改进临床工作提供依据。方法回顾性分析54例颅内动脉瘤患者的CTA、DSA和手术资料,进行结果对比分析。所有病例均于术前行CTA和DSA两种检查,54例患者中,14例栓塞治疗,40例行开颅手术。结果将CTA、DSA检查诊断结果与最终确诊结果比较,CTA检出颅内动脉瘤的敏感度为96.3%,准确度为98.6%;DSA检出颅内动脉瘤的敏感度为98.1%,准确度为98.6%,CTA的敏感度略高于DSA,但无统计学意义。CTA、DSA在准确显示动脉瘤立体形态等方面占检出动脉瘤的百分比分别为77.9%与57.3%。结论 CTA与DSA在颅内动脉瘤检出率方面无显著差异,两种检查方法都因为各自既有某些长处可以互相补充检查信息,不应以一种方法作为绝对的"金标准"。CTA对于颅内动脉瘤立体形态的显示情况优于DSA,为选定治疗方案提供了重要依据,但对于颈内动脉海绵窦段动脉瘤应着重参考DSA,DSA在动脉瘤诊治过程中仍起重要作用。

Objective To evaluate the value of CTA and DSA in the diagnosis and treatment of intracranial aneurysm and provide evidence to improve clinical work. Methods The clinical data of CTA,DSA and surgical data of 54 cases of intracranial aneurysms were analyzed retrospectively. The results were compared and analyzed. Of 54 patients performed with CTA and DSA,14 were treated with embolization and 40 were treated with craniotomy. Results CTA and DSA examination results were compared with the final diagnosis. The sensitivity of CTA was 96. 3%,and the accuracy was 98. 6%.While the sensitivity and accuracy of DSA were 98. 1% and 98. 6%. The sensitivity of CTA was little higher than that of DSA, but no statistical significance. In the accurate display of the threedimensional shape of the aneurysm by CTA and DSA,the percentage were 77. 9% and 57. 3%respectively. Conclusions There is no significant difference between CTA and DSA in the detection rate of intracranial aneurysms. The two methods are all because they have some good points,they can complement each other,and they should not be used as a＂gold standard＂. CTA is superior to DSA in the stereoscopic display of intracranial aneurysms,it provides an important basis for the selection of treatment scheme. But for the intracavernous internal carotid artery aneurysm should refer to DSA,DSA still plays an important role in the process of diagnosis and treatment of aneurysm.