动脉瘤应用64排CTA检查的临床研究

A Clinical Study of 64-slice CTA for Intracranial Aneurysm

目的研究64排CT血管成像(CT angiography,CTA)检查动脉瘤(intracranial aneurysm,IA)的临床应用。方法回顾性分析我院收治的49例自发性蛛网膜下腔出血患者的64排CTA影像资料,采用容积再现、最大密度投影图像后处理手段对所获取影像资料进行分析,并以数字减影血管造影为"金标准",计算64排CTA的灵敏度、特异度、准确率、阳性预测值、阴性预测值、一致性。结果 49例SAH患者中,经DSA共检出45例52个IA,其载瘤动脉依次为大脑前动脉5个、大脑中动脉7个、大脑后动脉2个、前交通动脉16个、后交通动脉3个、颈内动脉C1段17个、椎动脉2个;经64排CTA共检出46例55个IA,载瘤动脉依次为大脑前动脉5个、大脑中动脉6个、前交通动脉16个、后交通动脉6个、颈内动脉17个、椎动脉5个,64排CTA检查诊断IA的灵敏度为100.00%、特异度75.00%、准确率93.87%、阳性预测值97.72、阴性预测值60.00%,一致性为0.846,提示一致性良好。结论 64排CTA应用于动脉瘤的临床检查,不仅价格相对低廉、安全性佳,亦能清晰反应IA形态、位置、与周围结构的毗邻关系。

Objective To study the clinical application of 64-slice CTA in the diagnosis of intracranial aneurysms.Methods The 64-slice CTA imaging data of 49 patients with spontaneous subarachnoid hemorrhage in our hospital were analyzed retrospectively.The imaging data were analyzed by volume rendering and maximum intensity projection,and the sensitivity,specificity,accuracy,positive predictive value,negative predictive value and consistency of 64-slice CTA were calculated with digital subtraction angiography as the golden standard.Results In 49 patients with SAH,52 IA in 45 cases were detected by DSA,and parent arteries included 5 anterior cerebral artery(ACA),7 middle cerebral artery(MCA),2 posterior cerebral artery(PCA),16 anterior communicating artery(AComA),3 posterior communicating artery(PComA),17 internal carotid artery C1 segments(ICA)and 2 vertebral artery(VA).A total of 55IA in 46 patients were detected by 64-slice CTA,and parent arteries included 5 ACA,6 MCA,16 AComA,6 PComA,17 ICA and 5 VA.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and consistency(kappa)of 64-slice CTA in the diagnosis of IA were 100.00%,75.00%,93.87%,97.72%,60.00%and 0.846 respectively,suggesting good consistency.Couclusion 64-slice CTA in IA is not only cheap and safe but also can clearly reflect the shape,location and the adjacent relationship with the surrounding structure of IA.