CT血管成像与数字减影血管造影诊断颅内小动脉瘤对照研究

A Comparative Study of CT Angiography and Digital Subtraction Angiography in the Diagnosis of Intracranial Small Aneurysms

目的研究CT血管成像(CTA)与数字减影血管造影(DSA)诊断颅内小动脉瘤的临床价值。方法选择本院2018年4月到2020年7月60例颅内动脉瘤患者作为研究对象,均进行CTA与DSA检查,比较两种检查方式对颅内小动脉瘤的显示情况。结果3D-DSA检查结果显示,60例患者中42例为颅内小动脉瘤,其中9例为多发性,包括双侧颈内动脉后交通段1例,左侧大脑中动脉及左侧大脑后动脉1例,双侧颈内动脉海绵窦段1例,右侧C1及左侧V31例,基底动脉末端及右侧颈内动脉后交通及左侧M11例,左侧颈内动脉多发血管瘤1例,双侧颈内动脉及前交通动脉1例,左侧C6及左侧小脑后下1例,右侧后交通多发1例;33例为单发性颅内小动脉瘤,其中前交通动脉瘤9例,颈内动脉17例,后交通动脉4例,豆纹动脉远端1例,左侧脉络膜前动脉1例,右侧小脑后下1例。CTA和DSA的瘤体平均直径、瘤颈平均直径比较,差异均无统计学意义(P﹥0.05)。42例颅内小动脉瘤患者中,CTA共检查出57个小动脉瘤,其中55个与DSA检查结果一致,1例为假阴性,因位于右侧颈内动脉床突段,瘤体较小漏诊;1例为假阳性,CTA检查在左侧颈内动脉眼段,DSA检查在左侧颈内动脉眼段背侧。以3D-DSA检查结果为准,CTA检查敏感度为96.49%,特异度98.25%,Kappa值为0.91,表明CTA和3D-DSA检查颅内小动脉瘤的一致性优。结论CTA和DSA在颅内小动脉瘤诊断中均有较高的价值,且CTA与3D-DSA一致性良好,可作为颅内小动脉瘤常用诊断方法。

Objective To study the clinical value of CT angiography(CTA)and digital subtraction angiography(DSA)in the diagnosis of intracranial small aneurysms.Methods Sixty patients with intracranial aneurysms in our hospital from April 2018 to July 2020 were selected as the research objects.All were examined by CTA and DSA to compare the display of small intracranial aneurysms in the two inspection methods.Results The results of 3D-DSA examination showed that 42 of the 60 patients were intracranial aneurysms,9 of them were multiple,including 1 case in the posterior communicating segment of the bilateral internal carotid arteries,left middle cerebral artery and left posterior cerebral artery 1 case,1 case of bilateral internal carotid cavernous sinus segment,1 case of right C1 and left V3,1 case of basilar artery end and right internal carotid artery posterior communication and left M1,left internal carotid artery with multiple hemangioma 1 case,1 case of bilateral internal carotid artery and anterior communicating artery,1 case of left C6 and left posterior inferior cerebellum,1 case of right posterior communication.33 cases were single intracranial small aneurysms,including 9 cases of anterior communicating aneurysm,17 cases of internal carotid artery,4 cases of posterior communicating artery,1 case of distal lenticula artery,1 case of left anterior choroidal artery,right 1 case was lowered behind the cerebellum.There was no statistically significant difference between the average diameter of tumor body and the average diameter of tumor neck between CTA and DSA(P﹥0.05).Among 42patients with intracranial small aneurysms,57 small aneurysms were detected by CTA,55 of which were consistent with the results of DSA examination,and 1 case was false-negative because it was located in the right internal carotid artery clinoid segment and the tumor was small Missed diagnosis.One case was false positive.CTA was performed on the left internal carotid artery and DSA was performed on the dorsal side of the left internal carotid artery.Based on the results of the 3D-DSA examination,the sensitivity of the CTA examination was 96.49%,the specificity was 98.25%,and the Kappa value was 0.91,indicating that CTA and 3D-DSA have excellent consistency in the examination of intracranial aneurysms.Conclusion CTA and DSA have high value in the diagnosis of intracranial small aneurysms,and CTA and 3D-DSA have good consistency,and can be used as a common diagnostic method for intracranial small aneurysms.