双能减影CTA在脑动静脉畸形中的临床应用

Clinical application value of dual-energy subtract CTA of cerebral arteriovenous malformations

目的探讨双能减影CTA(DE-CTA)在脑动静脉畸形(CAVM)中的临床应用价值。方法收集2011年3月~2016年4月期间,对63例脑内动静脉畸形患者行头颈部DE-CTA检查,通过双能软件内骨移除处理,对所有二维、三维图像行容积再现(VR)、最大密度投影(MIP)处理,并由两名有经验的放射科医师对其进行分析。以DSA作为诊断金标准进行对照分析,采用SPSS 19.0统计软件进行数据处理,对DE-CTA和DSA结果进行Kappa一致性检验,评价DE-CTA检查在检测瘤巢大小、引流静脉及供血动脉方面的能力。结果在63例CAVM患者中,男39例,女24例,性别差异具有统计学意义(P<0.05);其中27例经DSA证实,DE-CTA与DSA的符合率为100%,在判断AVM病灶位置、大小、引流静脉及供血动脉方面,两种检查一致性极好(K=1,P<0.05)。结论 DE-CTA具有无创、安全、简便快捷等优点,能清楚显示CAVM瘤巢位置、大小、主要供血动脉和引流静脉,且有很高的诊断准确性。

Objective To explore clinical application value of dual-energy subtract CTA in cerebral arteriovenous malformations. Methods Between Mar. 2011 and Apr. 2016,63 patients with suspected arteriovenous malformations underwent dual-energy CT for the head. All data were postprocessed using the software of dual-energy（ head bone removal）. Two-dimensional and three-dimensional reformation were performed in all cases by means of curved vomule rendering（ VR）,maximum intensity projection（ MIP） respectively. All cases were analysed by two experienced radiologists. All results of DE-CTA were documented in a standardized scoring sheet,and blind to the results of DSA examinations. SPSS 19. 0 statistical software was used for data processing. DE-CTA and DSA results were assessed using Kappa consistency test to evaluate the ability to detect the size of the nidus,draining veins and feeding arteries. Results Of 63 patients,39 cases were male and 24 cases were feomal,the difference was statistically significant（ P〈0. 05）. 27 patients underwent DSA and findings were concordant for both techniques. The detection rate in DE-CTA was 100%. The results of DE-CTA in all 27 cases were fully consistent with DSA in displaying locations,size and draining veins of CAVM（ K = 1,P〈0. 05）. Conclusion As a non-invasive,safely and quick method,DE-CTA could clearly display all the lesions of CAVM,including size,locations,feeding arteries and drainage veins,which has a high diagnontic accuracy.