3D-TOF-MRA与CTA对未破裂颅内动脉瘤诊断价值的对比研究

Comparative study of 3D-TOF-MRA and CTA in the diagnosis of unruptured intracranial aneurysms

目的:探讨时间飞跃法磁共振血管成像(three-dimensional time of flight MRA,3D-TOF-MRA)与CT血管造影(CT angiography,CTA)对未破裂颅内动脉瘤(unruptured intracranial aneurysms,UIAs)的诊断价值。方法:回顾性收集2019年7月—2022年6月经数字减影血管造影(digital subtraction angiography,DSA)确诊为UIAs 52例患者的3D-TOF-MRA及CTA图像,比较MRA和CTA对颅内动脉瘤的检出率、瘤体最大径及瘤体颈宽测量结果的差异,MRA和CTA对颅内动脉瘤检出的一致性采用Kappa检验。结果:DSA确诊的52例患者中,共检出动脉瘤63个,MRA及CTA分别检出真实动脉瘤52个及53个,检出率分别为82.54%及84.13%,两者的差异无统计学意义(P>0.05),且两者对颅内动脉瘤的检出具有良好的一致性(Kappa=0.94);MRA与CTA对颅内动脉瘤瘤体最大径及瘤体颈宽测量结果的差异无统计学意义(P>0.05)。结论:3D-TOF-MRA与CTA在UIAs的诊断中均具有较高的价值,但3D-TOF-MRA是一种无电离辐射、无需注射对比剂的无创检查,方便重复检查,故UIAs的筛查和定期随访首选3D-TOF-MRA。

Objective To investigate the diagnostic value of 3D-TOF-MRA and CT angiography(CTA)in unruptured intracranial aneurysm unruptured intracranial aneurysms(UIAs).Methods The 3D-TOF-MRA and CTA images of 52 patients diagnosed as UIAs by digital subtraction angiography(DSA)from July 2019 to June 2022 were retrospectively collected.The differences between MRA and CTA were compared in the detection rate of intracranial aneurysm,and in the measurement results of intracranial aneurysm maximum diameter and tumor neck.The consistency of MRA and CTA for the detection of intracranial aneurysm was analyzed by Kappa test.Results Among the 52 confirmed patients,63 aneurysms were detected by DSA,52 aneurysms were detected by MRA and 53 by CTA.The detection rates of MRA and CTA were 82.54%and 84.13%respectively,and the difference was not statistically significant(P>0.05).The consistency of MRA and CTA for the detection of intracranial aneurysms were excellent(Kappa=0.94).MRA and CTA showed no significant difference in the measurement results of intracranial aneurysm maximum diameter and tumor neck(P>0.05).Conclusion Both 3D-TOF MRA and CTA have high diagnostic value in UIAs.However,3D-TOF-MRA is a noninvasive test without ionizing radiation and without injection of contrast agent,which is convenient for repeated examination.Therefore,3D-TOF-MRA is the first choice for UIAs screening and regular follow-up.