多层螺旋CT血管成像动态图像后处理对脑血管畸形病变的诊断价值

Diagnostic value of multi-slice spiral computed tomography angiography for cerebral vascular malformations

目的探讨多层螺旋CT血管成像动态图像(MSCTA)处理后对脑血管畸形病变(CVM)的诊断价值。方法选取2021年10月至2022年10月江西省黎川县中医医院收治的80例疑似CVM的患者作为研究对象,均采用美国GE 64排128层螺旋CT进行扫描,分析多层螺旋CT诊断CVM的检出率,并以数字减影血管造影(DSA)作为金标准,采用Kappa一致性检验,分析MSCTA的CT多平面重组(MPR)、三维容积漫游(VRT)及联合检测CVM诊断及分型的一致性。结果80例疑似CVM的患者经DSA确诊36例,未发生CVM 44例。MPR、VRT及联合检测诊断CVM的敏感度、特异度、准确度和Kappa值分别为83.33%、90.91%、87.50%、0.746;80.56%、86.36%、83.75%、0.671;94.44%、84.09%、88.75%、0.776。36例CVM患者经金标准确诊动静脉畸形19例、毛细血管畸形11例、海绵状血管畸形6例。MPR诊断CVM不同类型的符合率为75%(27/36),VRT诊断CVM不同类型的符合率为67%(24/36),联合检测的诊断CVM不同类型的符合率为83%(30/36)。MPR、VRT和联合检测诊断CVM不同类型中的Kappa值分别为0.822、0.744、0.845。结论采用MSCTA的MPR和VRT诊断CVM病变较为准确,有较好的临床诊断价值。

Objective To explore the diagnostic value of multi-slice spiral computed tomography angiography(MSCTA)for cerebral vascular malformations(CVM).Methods A total of 80 patients with suspected CVM in Lichuan County Hospital of Traditional Chinese Medicine,were enrolled as the research objects between October 2021 and October 2022.All underwent scans by GE 64-slice and 128-slice spiral CT.The detection rate of CVM by multi-slice spiral CT was analyzed.Taking digital subtraction angiography(DSA)as the golden standard,the consistency and classifications of CT multi-planar reconstruction(MPR),three-dimensional volume rendering technique(VRT)and combined detection in the diagnosis of CVM were analyzed by Kappa consistency test.Results Among the 80 patients with suspected CVM,DSA showed that there were 36 cases with CVM and 44 cases without.The sensitivity,specificity,accuracy and Kappa values of MPR,VRT and combined detection in the diagnosis of CVM were(83.33%,90.91%,87.50%,0.746),(80.56%,86.36%,83.75%,0.671)and(94.44%,84.09%,88.75%,0.776),respectively.Among the 36 patients with CVM,the golden standard showed that there were 19 cases with arteriovenous malformations,11 cases with capillary malformations and 6 cases with cavernous vascular malformations.The coincidence rates of MPR,VRT and combined detection in the diagnosis of different classifications of CVM were 75%(27/36),67%(24/36)and 83%(30/36),respectively.Kappa values of MPR,VRT and combined detection in the diagnosis of different classifications of CVM were 0.822,0.744 and 0.845,respectively.Conclusion MPR and VRT in MSCTA have high diagnostic accuracy for CVM.