MSCTA与3D-TOF MRA对颅内动脉瘤的应用价值对比

Comparison of the application value of MSCTA and 3d-tof MRA in intracranial aneurysms

目的:分析多层螺旋CT血管成像(MSCTA)与三维时间飞跃法磁共振血管成像(3D-TOF MRA)技术对颅内动脉瘤(IA)的应用价值。方法:收集50例经数字减影血管造影(DSA)确诊IA患者的临床资料,以DSA为检验标准,分析MSCTA与3D-TOF MRA对IA的检出情况,以及对瘤体直径、瘤颈宽度测量结果的差异。结果:50例患者DSA共检出瘤体58个,MSCTA共检出瘤体55个,3D-TOF MRA共检出瘤体47个。MSCTA对IA的总体检出率高于3D-TOF MRA,MSCTA对Ⅰ级IA(直径≤3mm)的检出率高于3D-TOF MRA,差异均有统计学意义(P<0.05),MSCTA与3D-TOF对IA瘤体最大径、瘤颈宽度测量结果的差异均无统计学意义(P>0.05)。结论:MSCTA对IA的总体检出率及Ⅰ级IA的检出率要优于3D-TOF MRA,但3D-TOF MRA无电离辐射,无需注射对比剂,且两者对瘤体直径、瘤颈宽度的测量均较为准确。两种方法均可应用于IA的筛查,可根据患者自身情况选择合理检查方式,但对3D-TOF MRA检查阴性、临床又高度疑似IA的患者,应警惕直径≤3mm MMD小瘤体的存在,以避免发生漏诊、误诊。

Objective To analyze the application value of multi-slice spiral CT angiography(MSCTA)and threedimensional time-lapse magnetic resonance angiography(3d-tof MRA)in intracranial aneurysm(IA).Methods The clinical data of 50 patients diagnosed with IA by digital subtraction angiography(DSA)were collected,and the detection of IA by MSCTA and 3d-tof MRA were analyzed with DSA as the test standard,as well as the differences in the measurement results of tumor diameter and tumor neck width.Results 58 tumors were detected by DSA,55 by MSCTA and 47 by 3d-tof MRA.MSCTA overall detection rate of IA is higher than 3d TOF MRA,MSCTA level ofⅠIA(diameter 3 mm or less)the detection rate is higher than 3d-TOF MRA,the differences were statistically significant(P<0.05),MSCTA with 3d-TOF on IA tumors had the largest diameter,the differences between the tumor neck width measurement results had no statistical significance(P>0.05).Conclusion MSCTA overall detection rate of IA and IAⅠlevel detection rate is better than 3d TOF MRA,but no ionizing radiation,the 3d-TOF MRA without contrast medium injection,and both of tumors,tumor diameter neck width measurement are more accurate.Both methods can be applied to IA screening,and a reasonable method of examination can be selected according to the patient's own conditions.However,for patients with negative 3d-tof MRA test and clinically highly suspected IA,the existence of MMD nodules with diameter≤3mm should be vigilant to avoid missed diagnosis and misdiagnosis.