MSCTA不同后处理技术诊断基底动脉扩张延长的结果对比

Comparison of different post-processing techniques of MSCTA in the diagnosis of basilar artery dolichoectasia

目的:探讨多层螺旋CT血管成像(multi-slice spiral CT angiography,MSCTA)不同后处理技术对基底动脉扩张延长(basilar artery dolichoectasia,BD)检出的一致性并比较各诊断方式的诊断效能。方法:回顾性收集我院放射科行头颈MSCTA的125例病人CT资料,其中经目前公认的CTA诊断方式多平面重组(multiplanar reformation,MPR)诊断为BD的17例、非BD108例,运用Kappa检验分别将容积再现(volume rendering,VR)、血管分析(vessel extraction)联合测量工具(Inspect&Measure)对125例病人的BD诊断结果与MPR法诊断结果进行一致性分析,并运用Medcalc软件计算VR法和血管分析法的诊断试验评价指标。结果:125例病人中,VR法、血管分析法分别检出BD12例(9.60%)、14例(11.20%)。Kappa检验结果显示,VR法与MPR法诊断BD的一致性中等(κ=0.650,P=0.000),血管分析法与MPR法诊断BD的一致性较好(κ=0.816,P=0.000)。VR法诊断BD的灵敏度(Se)、特异度(Sp)、阳性预测值(PPV)、阴性预测值(NPV)、准确性指数(IV)分别为58.82%、98.15%、83.33%、93.81%、0.928;血管分析法为76.47%、99.07%、92.86%、96.40%、0.960。结论:血管分析法Se、Sp、PPV、NPV、IV均高于VR法,其与MPR法诊断BD的一致性较好,有望成为MSCTA诊断BD的一种全定量诊断方式。

Objective:To determine the consistency in the detection of basilar artery dolichoectasia(BD)by multi-slice spiral CT angiography(MSCTA)using different post-processing techniques and to compare the diagnostic efficacy of various diagnostic methods.Methods:CT images of 125 patients who underwent head and neck MSCTA in the Radiology Department of our hospital were reviewed. Of the 125 patients,17 were diagnosed with BD and 108 were diagnosed with non-BD,according to the results of multiplanar reformation(MPR),which is currently the accepted diagnostic method for CTA. The consistency between BD diagnosis results determined by volume rendering(VR),vessel extraction(VE)and inspect & measure tool and MPR diagnosis results for the 125 patients was determined using the Kappa test. Evaluation indices of the VR and VE based diagnostic tests were determined using Medcalc software. Results:Among the 125 patients,12(9.60%)and 14(11.20%)cases of BD were diagnosed by the VR and VE methods,respectively. Consistency in BD diagnosis was moderate between the VR and MPR methods (κ=0.650,P=0.000),and good between the VE and MPR methods(κ=0.816,P=0.000). The sensitivity(Se),specificity(Sp),positive predictive value(PPV),negative predictive value(NPV),and index of validity(IV)of the VR method for BD diagnosis were 58.82%,98.15%,83.33%,93.81%,and 0.928,respectively. The Se,Sp,PPV,NPV and IV of the VE method for BD diagnosis were 76.47%,99.07%,92.86%,96.40%,and 0.960,respectively. Conclusion:VE has higher Se,Sp,PPV,NPV,and IV than VR,and good consistency with MPR in the diagnosis of BD.Therefore,VE is a potential fully quantitative diagnostic method for MSCTA in the diagnosis of BD.