多层螺旋CT血管造影在颅内动脉瘤诊断中的应用价值

Application value of multi-slice spiral CT angiography in diagnosis of intracranial aneurysms

目的探讨多层螺旋CT血管造影(MSCTA)在颅内动脉瘤诊断中的应用价值。方法选取106例高度怀疑颅内动脉瘤患者为研究对象,均予以外科手术病理检查、MSCTA及数字减影血管造影(DSA)检查。以外科手术病理检查结果为"金标准"评估MSCTA检查及DSA检查的特异性、敏感性及准确性差异。结果此次入组的106例高度怀疑颅内动脉瘤患者中,经外科手术病理检查,确诊颅内动脉瘤98例(共检出102个动脉瘤),其中96例为单发病灶,2例为多发病灶(各检出3个动脉瘤);剩余8例受试者检测结果为阴性。MSCTA检查结果显示其特异性、敏感性及准确性分别为87.5%(7/8)、94.1%(96/102)和93.6%(103/110);DSA检查结果显示其特异性、敏感性及准确性分别为87.5%(7/8)、99.0%(101/102)和98.2%(108/110),对比差异无统计学意义(P>0.05)。结论对高度怀疑颅内动脉瘤患者予以MSCTA检查,可有效提高诊断准确性及有效性,操作性强且能清晰反映颅内动脉瘤与周围组织的解剖关系,值得临床推广。

Objective To investigate the application value of multi - slice spiral CT angiography （MSCTA） in the diag- nosis of intracranial aneurysms. Methods Totally 106 cases of patients with highly suspected intracranial aneurysms were selected as the research objects. All of them were examined by surgery and pathology, MSCTA and digital subtrac- tion angiography （DSA）. The results of surgery and pathology were taken as the gold standard to evaluate the differences in specificity, sensitivity and accuracy of MSCTA and DSA. Results Among the 106 patients with high suspected in- tracranial aneurysms, there were 98 cases of intracranial anenrysms confirmed by surgery and pathology （102 detected aneurysms in total）, including 96 cases of single - attack lesions and 2 cases of multi - attack lesions （3 aneurysms de- tected, respectively）. The test results of the remaining 8 subjects were negative. The results of MSCTA showed that the specificity, sensitivity and accuracy were 87.5% （7/8）, 94. 1% （96/102） and 93. 6% （103/110）, respectively. The results of DSA showed that the specificity, sensitivity and accuracy were 87.5 % （7/8） , 99.0% （ 101/102 ） and 98.2% （ 108/110）, respectively. The differences were not statistically significant （P 〉 0. 05 ）. Conclusion To exam- ine patients who have intracranial aneurysms with MSCTA can effectively improve the diagnostic accuracy and validity, with strong operability and it can clearly reflect the anatomic relationship between intracranial aneurysms and surrounding tissues. It is worthy of clinical promotion.