双源CT数字减影CTA与双能量CTA检出颅内动脉瘤的准确性

目的 以常规DSA和三维旋转DSA为参照标准,评价双源CT数字减影去骨CT血管成像(DS-BR-CTA)和双能量直接去骨CTA(DE-CTA)诊断颅内动脉瘤的价值.方法 190例患者接受DS-BR-CTA检查,74例患者接受DE-CTA检查.以3D-DSA为标准,以患者和发生部位为单位,计算DS-BR-CTA和DE-CTA诊断颅内动脉瘤的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV).结果 DS-BR-CTA诊断敏感性和特异性分别为96.90%、98.36%;97.37%、99.97%;对≤3.0 mm的动脉瘤,其诊断敏感性高达88.89%,特异性达98.36%;DE-CTA检测颅内动脉瘤的诊断敏感性和特异性分别为98.25%、100%;95.52%、100%,对≤3.0 mm动脉瘤的敏感性为90.91%,特异性为100%.结论 双源CT的DE-CTA诊断颅内动脉瘤的准确性与DS-BR-CTA相当,可作为常规技术用于颅内动脉瘤的诊断流程中.

Diagnosis of intracranial aneurysms: accuracy of digital subtraction bone removal CT angiography and dual energy bone removal CTA

Objective To evaluate the diagnostic accuracy of digital subtraction bone removal CT angiography (DS-BR-CTA) and dual energy bone removal CTA (DE-CTA) compared with conventional and rotational DSA. Methods A total of 264 patients underwent 3D-DSA were enrolled, 190 of them underwent also DS-BR-CTA, while 74 underwent DE-CTA as well. Aneurysms detected with DS-BR-CTA and DE-CTA were analyzed compared with 3D-DSA on per-patient and per-aneurysm basis. The sensitivity, specificity, positive predictive value and negative predictive value of two methods for diagnosis of aneurysm were calculated. Results Taking DSA as the standard, the sensitivity and specificity of DS-BR-CTA to detect intracranial aneurysms was 96.90％ and 98.36％ on per-patient basis, while 97.37％ and 99.97％ on per-aneurysm basis, and the sensitivity and specificity for the detection of aneurysm ≤3 mm was 88.89% and 98.36%. The sensitivity and specificity of DS-BR-CTA to detect intracranial aneurysms was 98.25% and 100% on per-patient basis, 95.52% and 100% on per-aneurysm basis, and the sensitivity and specificity for the detection of aneurysm ≤3 mm was 90.91% and 100%. Conclusion DE-CTA has a comparable diagnostic accuracy with DS-BR-CTA to diagnose intracranial aneurysms, and can be used in the routine workflow for detection of intracranial aneurysms.