MSCTA三维重建在颅内动脉瘤诊断中的应用价值

Application effects of MSCTA three-dimensional reconstruction in diagnosis of intracranial aneurysms

目的:观察多层螺旋CT血管造影(MSCTA)三维重建在颅内动脉瘤诊断中的应用价值。方法:选取2018年1月至2021年12月该院收治的70例疑似颅内动脉瘤患者进行前瞻性研究,所有患者均接受头颅脑血管磁共振成像(MRA)、MSCTA三维重建、数字减影血管造影(DSA)检查,以DSA检查结果为“金标准”,比较MRA、MSCTA检查在颅内动脉瘤中的诊断效能,并分析MRA、MSCTA与DSA检查在不同直径颅内动脉瘤诊断中的一致性。结果:经DSA检查结果显示,阳性53例,阴性17例,包括动脉瘤59个,其中动脉瘤直径>10 mm 2个,6~10 mm 4个,4~5 mm 19个,≤3 mm 34个;MRA检查结果显示,阳性48例,阴性22例;MSCTA三维重建检查结果显示,阳性54例,阴性16例;MSCTA三维重建检查诊断颅内动脉瘤的准确度、阳性预测值及阴性预测值均高于MRA检查,差异有统计学意义(P<0.05);MRA检查诊断不同直径颅内动脉瘤与DSA检查结果的一致性理想(Kappa=0.482,P<0.05),MSCTA三维重建检查诊断不同直径颅内动脉瘤与DSA检查结果的一致性极好(Kappa=0.940,P<0.05)。结论:MSCTA三维重建检查诊断颅内动脉瘤的效能高于MRA检查诊断效能。

Objective:To observe application effect of multi-slice spiral CT angiography(MSCTA)three-dimensional reconstruction in diagnosis of intracranial aneurysms.Methods:A prospective study was conducted on 70 patients with suspected intracranial aneurysms admitted to the hospital from January 2018 to December 2021.All patients underwent head cerebrovascular magnetic resonance imaging(MRA),MSCTA threedimensional reconstruction,and digital subtraction angiography(DSA).Using the results of DSA as the gold standard,the diagnostic efficacies of MRA and MSCTA for intracranial aneurysms were compared.The consistency of MRA,MSCTA and DSA in the diagnosis of intracranial aneurysms with different diameters was also compared.Results:DSA examination results of the 70 patients showed that 53 cases were positive and 17 cases were negative,including 59 aneurysms,including 2 aneurysms with diameter>10 mm,4 aneurysms with diameter 6-10 mm,19 aneurysms with diameter 4-5 mm and 34 aneurysms with diameter≤3 mm.MRA showed that 48 cases were positive and 22 cases were negative.MSCTA threedimensional reconstruction showed that 54 cases were positive and 16 cases were negative.The sensitivity,the specificity,the accuracy,the positive predictive value and the negative predictive value of MSCTA three-dimensional reconstruction in the diagnosis of intracranial aneurysms were higher than those of MRA,and the differences were statistically significant(P<0.05).The consistency between MRA and DSA in the diagnosis of intracranial aneurysms with different diameters was ideal(Kappa=0.482,P<0.05),and the consistency between MSCTA three-dimensional reconstruction and DSA was excellent(Kappa=0.940,P<0.05).Conclusions:The diagnostic efficiency of MSCTA three-dimensional reconstruction in the diagnosis of intracranial aneurysms is higher than that of MRA.