超高分辨率减影CT血管成像在颅内动脉瘤治疗后随访中的应用

Application of Ultra-High Resolution Subtraction CT Angiographyin the Follow-Up after Intracranial Aneurysm Treatment

目的:研究超高分辨率减影计算机X线断层扫描(CT)血管成像(CTA)在颅内动脉瘤治疗后随访中的应用效果。方法:回顾性分析2020年6月至2022年1月期间于我院治疗的98例颅内动脉瘤患者的临床资料,患者于术后3个月复查时实施超高分辨率减影CTA和数字减影血管造影(DSA)检查,以DSA检查为“金标准”,分析超高分辨率减影CTA诊断颅内动脉瘤患者治疗后动脉瘤闭塞、瘤颈残留、载瘤动脉及颅内大血管通畅情况以及有无术后脑血管痉挛(CVS)、新生动脉瘤的诊断价值。结果:超高分辨率减影CTA用于诊断颅内动脉瘤患者治疗后动脉瘤闭塞的敏感度为97.87%(92/94),特异度为75.00%(3/4),准确度为96.94%(95/98);诊断颅内动脉瘤患者治疗后瘤颈残留的敏感度为95.70%(89/91),特异度为85.71%(6/7),准确度为96.94%(95/98);诊断颅内动脉瘤患者治疗后载瘤动脉及颅内大血管通畅情况的敏感度为98.89%(89/90),特异度为62.50%(5/8),准确度为95.92(94/98);诊断颅内动脉瘤患者治疗后有无CVS的敏感度为62.50%(5/8),特异度为98.89%(89/90),准确度为95.92%(94/98);诊断颅内动脉瘤患者治疗后有无新生动脉瘤的敏感度为50.00%(1/2),特异度为98.96%(95/96),准确度为97.96%(96/98)。结论:超高分辨率减影CTA用于诊断颅内动脉瘤患者肿瘤及血管情况诊断准确度高,有利于术后随访诊断肿瘤闭塞情况及术后并发症情况,可为判断临床随访提供依据,帮助临床制定后续治疗方案。

Objective:To study the application effects of ultra-high resolution subtraction computed tomography(CT)angiography(CTA)in the follow-up after treatment for intracranial aneurysms.Methods:The clinical data of 98 patients with intracranial aneurysms who were treated in the hospital from June 2020 to January 2022 were retrospectively analyzed.The patients underwent ultra-high resolution subtraction CTA and digital subtraction angiography(DSA)review at 3 months after surgery.Taking DSA as the"gold standard"to analyze the diagnostic value of ultra-high resolution subtraction CTA in diagnosing aneurysm occlusion,residual aneurysm neck,parent artery and intracranial macrovascular patency and presence or absence of postoperative cerebral vasospasm(CVS)and new aneurysm in patients with intracranial aneurysms after treatment.Results:The sensitivity,specificity and accuracy of ultra-high resolution subtraction CTA were 97.87%(92/94),75.00%(3/4)and 96.94%(95/98)in the diagnosis of aneurysm occlusion in patients with intracranial aneurysms after treatment,were 95.70%(89/91),85.71%(6/7)and 96.94%(95/98)in diagnosing residual aneurysm neck,were 98.89%(89/90),62.50%(5/8)and 95.92(94/98)in diagnosing the parent artery and intracranial macrovascular patency in patients with intracranial aneurysms after treatment,were 62.50%(5/8),98.89%(89/90)and 95.92%(94/98)in diagnosing the presence or absence of CVS,and were 50.00%(1/2),98.96%(95/96)and 97.96%(96/98)in the diagnosis of presence or absence of new aneurysm after treatment.Conclusion:Ultra-high resolution subtraction CTA has high diagnostic accuracy in diagnosing tumors and blood vessels in patients with intracranial aneurysms,and it is helpful for postoperative follow-up diagnosis of tumor occlusion and postoperative complications,and can provide a basis for judging clinical follow-up and help clinical formulation of follow-up treatment regimen.