三维CTA在颅内动脉瘤患者中的临床诊断价值分析

Clinical Value of Three Dimensional Cta in Patients with Intracranial Aneurysm

目的分析三维CT血管造影(CTA)在颅内动脉瘤患者中的临床诊断价值。方法回顾性分析我院于2013年1月-2016年3月期间,术后确诊的21例颅内动脉瘤患者的临床资料,所有患者均进行三维CTA及数字减影血管造影(DSA)检查,对比两种检查方法对颅内动脉瘤的诊断效果,并分析三维CTA对颅内动脉瘤病灶的显示情况。结果与最终诊断对比,三维CTA对颅内动脉瘤的诊断准确性为93.33%、敏感性为96.55%、阳性预测值为96.55%;DSA对颅内动脉瘤的诊断准确性为93.10%、敏感性为100.00%、阳性预测值为93.10%;两组数据均无显著性差异(P>0.05);三维CTA对动脉瘤瘤体、瘤颈的显著效果优于DSA,三维CTA可观察动脉瘤的三维立体结构,清晰显示载瘤动脉及术区解剖结构。结论三维CTA对颅内动脉瘤的临床诊断价值与DSA相当,与手术诊断符合率高,对颅内动脉瘤病灶的显示效果优于DSA,可作为颅内动脉瘤的首选检查诊断方法之一。

Objective To analyze the clinical diagnostic value of three-dimensional CT angiography（CTA）in patients with intracranial aneurysms. Methods A retrospective analysis in January 2013 to March 2016,after confirmed the clinical data of 21 patients with intracranial aneurysms, all patients were performed 3 d CTA and digital subtraction angiography（DSA）inspection,compared to two kinds of checking methods for the diagnosis of intracranial aneurysm effect, and analyze the three-dimensional display of CTA for intracranial aneurysm lesions. Results Compared with the final diagnosis,the diagnostic accuracy of three-dimensional CTA for intracranial aneurysms was 93.33%, the sensitivity was 96.55%and the positive predictive value was 96.55%. The diagnostic accuracy of DSA for intracranial aneurysms was 93.10%, the sensitivity was 100.00%, and the positive predictive value was 93.10%. There was no significant difference between the two groups（P BBB 0.05）. Three-dimensional CTA has a better effect than DSA on the aneurysm and tumor of aneurysm.Three-dimensional CTA can observe the three-dimensional structure of aneurysms,and clearly show the anatomical structure of the tumor artery and the operative area. Conclusion 3 d CTA for intracranial aneurysm has the clinical diagnostic value of DSA,and surgical diagnosis coincidence rate is high,the display effect is superior to DSA for intracranial aneurysm lesion,can be used as one of the first choice for the intracranial aneurysms diagnosis method.