探讨全脑多倾斜角数字减影血管造影和3D旋转数字减影血管造影在颅内动脉瘤诊断中的应用价值

Application value of whole brain multiple-tilt angle DSA and 3D rotational DSA in the diagnosis of intracranial aneurysm

目的:探究对可疑动脉瘤患者进行多倾斜角数字减影血管造影(DSA)和3D旋转DSA诊断的应用价值。方法:选取119例可疑颅内动脉瘤患者为研究对象。所有患者均接受多倾斜角DSA和3D-DSA检查,比较两种造影技术对动脉瘤诊断的应用价值。结果:与多倾斜角DSA相比,3D-DSA可清楚显示动脉瘤及载瘤动脉血管平面情况。3D-DSA的颅内动脉瘤检出率高于多倾斜角DSA组(P<0.05),两种造影技术对不同部位、不同直径颅内动脉瘤检出率比较,差异均无统计学意义(P>0.05)。以手术检查结果为“金标准”,3D-DSA诊断颅内动脉瘤的灵敏度、准确率高于多倾斜角DSA(P<0.05),特异度比较,差异无统计学意义(P>0.05)。3D-DSA组患者动脉瘤颈、瘤颈-载瘤血管间关系、动脉瘤形态显示评分及图像质量评分均高于多倾斜角DSA组(P<0.05);造影剂剂量与辐射剂量均少于多倾斜角DSA组(P<0.05)。结论:3D旋转脑血管造影可提高动脉瘤检查图像质量、减少辐射剂量,为患者病情诊断提供有效依据,提高检查安全性。

Objective:To investigate the application value of multiple-tilt angle digital substraction angiography(DSA)and 3D rotational DSA in the diagnosis of intracranial aneurysm.Methods:119 patients suspected of intracranial aneurysm were selected as the research subjects.All patients were examined with multiple-tilt angle DSA and 3D-DSA.The application value of the two techniques in the diagnosis of intracranial aneurysm was compared.Results:Compared with multi-tilt angle DSA,3D-DSA could clearly display the status of aneurysm and parent artery.The detection rate of intracranial aneurysms by 3D-DSA was higher than that by multi-tilt angle DSA group(P<0.05).There was no statistically significant difference in the detection rates of intracranial aneurysms at different sites and in different diameters between the two imaging techniques(P>0.05).With surgical results as the golden standard,the sensitivity and accuracy of 3D-DSA in the diagnosis of intracranial aneurysm were higher than those of multi-tilt angle DSA(P<0.05),and there was no statistically significant difference in specificity(P>0.05).The scores for aneurysm neck,the relationship between aneurysm neck and parent vessel,and aneurysm morphology displayed,and the image quality score in the 3D-DSA group were higher than those in the multi-tilt angle DSA group(P<0.05).The dosage of contrast agent and radiation dose in the 3D-DSA group were lower than those in the multi-tilt angle DSA group(P<0.05).Conclusion:3D rotational cerebral angiography can improve the image quality and reduce the radiation dose.It can not only provide an effective basis for the diagnosis but also improve the safety of examination.