多层螺旋CT血管成像诊断颅内动脉瘤的价值

目的评估多层螺旋CT血管造影（MSCTA）及数字减影血管造影（DSA）对颅内动脉瘤的诊断价值。方法对36例动脉瘤性蛛网膜下腔出血患者分别行MSCTA及DSA检查，MSCTA图像后处理包括采用表面遮盖显示（SSD）、最大密度投影（MIP）、容积显示（VR）及曲面重建（CPR）等方法进行血管显示。结果36例蛛网膜下腔出血患者共发现38个动脉瘤，其中MSCTA发现34个，DSA发现35个，准确率分别是89％和92％，两者差异无统计学意义（P〉0．05）；4个CTA漏诊动脉瘤均小于3mm。CTA诊断直径〈3mm、3～10mm和〉10mm的动脉瘤敏感度分别为84％、95％和100％；动脉瘤的敏感度、特异度和准确度分别为88％、62％和87％；阳性预测值和阴性预测值分别为98％和94％。结论MSCTA对颅内动脉瘤的诊断具有较高价值，可以作为外科治疗或介入治疗颅内动脉瘤的筛选方法。

Diagnostic value of intracrania aneurysms using multislice computerized tomography angiography multi-slice CT angiography

Objective To evaluate the value of multislice computerized tomography angiography (MSCTA) and Digital subtraction angiography(DSA) in the detection and treatment of intracranial aneurysms. Methods 36 patients with aneurysmal subarachnoid hemorrhage were performed both MSCTA and DSA. Reconstruction types of MSCTA included shaded surface display (SSD), maximum intensity projection (MIP), volume rederening (VR), and curved plane reconstruction (CPR). Results A total of 38 aneurysms were found in 36 patients with aneurysmal subaxachnoid hemorrhage, among which 34 aneurysms were found by MSCTA, and 35 cases found by DSA. The accu-racy for MSCTA and DSA was 89% and 92% respectively. No statistical difference was found between these two methods (P>0.05). The sensitivity for detecting aneurysms <3 mm,3～10 mm and > 10 mm on a per-aneurysms basis was 84%, 95%, and 100%, respectively. The sensitivity specificity, and accuracy of CTA for detecting aneu-rysms on a per-patienbosis were 88%, 62%, and 87%, respectively. The predictive value of positive and negative were 98% and 94%. Conclusion MSCTA has diagnostic value in intracranial aneurysm and helpful for its screen-ing before surgery or interventional therapy.