64排CT血管成像和1.5T MRI血管成像技术对高度怀疑颅内动脉瘤患者的诊断效能比较

Comparison of Diagnostic Efficacy between 64 Row CT Angiography and 1.5T MRI Angiography in Patients with Highly Suspected Intracranial Aneurysms

目的:探讨64排CT血管成像(CTA)和1.5T MRI血管成像技术(MRA)对高度怀疑颅内动脉瘤患者的诊断效能。方法:选取2020年12月—2022年12月在广西柳钢医疗有限公司医院诊治的84例高度怀疑颅内动脉瘤患者为研究对象。所有患者均进行64排CTA检查和1.5T MRA检查,比较两种检查方式的影像学图像清晰度,并以数字减影血管造影(DSA)检查结果为“金标准”,计算64排CTA、1.5T MRA检查诊断颅内动脉瘤的敏感度、特异度、准确度,分析两种检查方式与金标准的一致性。比较两种检查方式对不同直径瘤体的诊断准确率。结果:64排CTA检查对颅内动脉瘤的影像图清晰程度明显优于1.5T MRA检查,差异有统计学意义(P<0.05)。64排CTA诊断颅内动脉瘤的敏感度、准确度分别为94.2%、91.7%,均显著高于1.5T MRA检查的79.7%、76.2%,差异有统计学意义(P<0.05)。Kappa检验分析显示,64排CTA检查诊断颅内动脉瘤与金标准的一致性较好(Kappa=0.723,P<0.05),1.5T MRA检查诊断颅内动脉瘤与金标准的一致性较差(Kappa=0.329,P<0.05)。两种检查方式对常规动脉瘤、大动脉瘤、超大动脉瘤的诊断准确率比较,差异无统计学意义(P>0.05),64排CTA检查诊断<3 mm的小动脉瘤的准确率高于1.5T MRA检查,差异有统计学意义(P<0.05)。结论:64排CTA和1.5T MRA对较大直径颅内动脉瘤的诊断效能差异不大,但CTA诊断小动脉瘤的准确率更高。

Objective:To explore the diagnostic efficacy of 64 row CT angiography(CTA)and 1.5T MRI angiography(MRA)in highly suspected intracranial aneurysm patients.Method:A total of 84 highly suspected intracranial aneurysm patients who were diagnosed and treated at the Hospital of Guangxi Liugang Medical Co.,Ltd from December 2020 to December 2022 were selected as the research subjects.All patients underwent 64 row CTA and 1.5T MRA examinations to compare the imaging image clarity of the two examination methods.The sensitivity,specificity,and accuracy of 64 row CTA and 1.5T MRA examinations in diagnosing intracranial aneurysms were calculated using the results of digital subtraction angiography(DSA)as the"gold standard",and the consistency between the two examination methods and the gold standard was analyzed.The diagnostic accuracy of two examination methods for tumors with different diameters was compared.Result:The imaging clarity of 64 row CTA examination for intracranial aneurysms was significantly better than that of 1.5T MRA examination,the difference was statistically significant(P<0.05).The sensitivity and accuracy of 64 row CTA in diagnosing intracranial aneurysms were 94.2%and 91.7%,respectively,significantly higher than 79.7%and 76.2%of 1.5T MRA examination,the differences were statistically significant(P<0.05).Kappa test analysis showed that the 64 row CTA examination showed good consistency with the gold standard for diagnosing intracranial aneurysms(Kappa=0.723,P<0.05),while the 1.5T MRA examination showed poor consistency with the gold standard for diagnosing intracranial aneurysms(Kappa=0.329,P<0.05).There were no statistically significant differences in the diagnostic accuracy between the two examination methods for conventional aneurysms,large aneurysms,and super large aneurysms(P>0.05).The accuracy of 64 row CTA examination for diagnosing small aneurysms<3 mm was higher than that of 1.5T MRA examination,and the difference was statistically significant(P<0.05).Conclusion:There is no significant difference in the diagnostic efficacy between 64 row CTA and 1.5T MRA for larger diameter intracranial aneurysms,but CTA has a higher accuracy in diagnosing small aneurysms.