磁共振血管造影、CT血管造影及数字减影血管造影对颅内动脉瘤诊断价值的对照研究

目的对照研究磁共振血管造影（MRA）、CT血管造影（CTA）及数字减影血管造影（DSA）对颅内动脉瘤的诊断价值。方法34例经DSA检查和（或）临床证实的颅内动脉瘤患者,均行DSA检查,并同时行CTA和（或）MRA检查。分析MRA、CTA及DSA对颅内动脉瘤的检出率,并观察分析动脉瘤的形态特征,测量动脉瘤瘤体直径及囊状动脉瘤瘤颈宽度。结果34例患者共检出动脉瘤41个,DSA、MRA及CTA的检出率分别为97.6%（40/41）、86.4%（19/22）和75.0%（15/20）。以DSA为诊断金标准,CTA与MRA检出率差异无统计学意义（P〉0.05）。CTA与DSA、MRA与DSA所测瘤体直径及瘤颈宽度差异均无统计学意义（P〉0.05）。结论DSA仍为检出颅内动脉瘤最敏感的方法,但MRA和CTA对于动脉瘤形态特征的显示可达到与DSA相同的水平,且MRA和CTA因无创、经济、快捷方便应作为首选检查方法,尤其MRA无需注入对比剂,使得检查更安全。

Comparison study of magnetic resonance angiography,CT angiography with digital subtraction angiography in intracranial aneurysm diagnosis

Objective To study the value of magnetic resonance angiography（MRA）,CT angiography（CTA） and digital subtraction angiography（DSA） in intracranial aneurysm diagnosis through a comparison method.Methods The study enrolled 34 patients with intracranial aneurysm approved by DSA and（or） clinical method.All patients underwent DSA examination,and simultaneously underwent MRA and（or） CTA examination.The detection rates of intracranial aneurysm MRA,CTA and DSA were analyzed,and the morphological characteristics of the aneurysm were explored.The body diameter of aneurysm and neck width of saccular aneurysm were measured.Results 41 intracranial aneurysms were detected among the 34 patients.The detection rates of DSA,MRA and CTA were respectively 97.6%（40/41）,86.4%（19/22） and 75.0%（15/20）.Taking DSA as golden standard,the difference of detection rates between MRA and CTA had no statistical significance（P0.05）.The differences of the aneurysms＇ body diameters and neck width of saccular aneurysm had no statistical significances between CTA and DSA,or between MRA and CTA（P0.05）.Conclusion DSA is still the most susceptible method in detection of intracranial aneurysms.The displays of morphological characteristics had no differences between MRA,CTA and DSA.Because of non-surgical,cheaper,quicker and more convenient features,we should firstly choose MRA and CTA examination,and especially MRA examination with no introduction of contrast medium making the process safer.