64排螺旋CT血管造影与3D DSA对颅内小动脉瘤诊断的比较分析

目的通过64排螺旋CT血管造影（CTA）与三维旋转数字减影血管造影（3D DSA）对颅内小动脉瘤检测的对照研究,评价64排CTA对颅内小动脉瘤的诊断价值。方法 2007年6月—2010年12月疑似颅内动脉瘤患者73例,回顾性分析其64排CTA及3D DSA图像资料,以3D DSA为诊断标准,采用双盲法对比分析64排CTA对颅内小动脉瘤的诊断价值。结果 3D DSA共检出47例,合计52个小动脉瘤。颅内小动脉瘤组（直径3～5 mm）32个,其中CTA检出32个,CTA的诊断灵敏度、特异度均为100%;颅内微小动脉瘤组（直径〈3 mm）20个,其中CTA检出19个,假阴性1例和假阳性4例。CTA的诊断灵敏度、特异度和准确性分别为91.8%、86.0%和91.5%。64排CTA对颅内小及微小动脉瘤诊断与DSA比较两组间差异无统计学意义（P〉0.05）。结论 64排螺旋CTA的应用,提高了对颅内小动脉瘤的检出能力,CTA可作为颅内小动脉瘤筛选检测的首选方法。

Comparison of the diagnostic value of 64 MDCT angiography with 3D digital subtraction arteriography for detecting encephalic small aneurysm

Objective To evaluate the diagnostic value of 64 MDCT angiography（CTA） for detecting the small intracranial aneurysm through comparison with that of rotation 3D DSA.Methods Between June,2007 and December,2010,73 patients clinically suspected intracranial aneurysms and accepted both 3D DSA and CTA examination were retrospectively reviewed with comparison of study.Two reviewers blindly of the DSA results read the CTA images,taking the 3D rotation digital subtraction angiography（DSA） as the gold standard for evaluating the diagnostic value of CTA.Results There were totally 52 small aneurysms detected by DSA in 47 patients.In 32 small aneurysms-group,64-CTA detected the 32 aneurysms of which the maximum diameter was less than 5mm and more than 3mm.For detecting the small aneurysm,the sensitivity,specificity,accuracy of 64-CTA were 100%.In 20 tiny aneurysm-group with maximum diameter less than 3mm,64-CTA detected the 19 aneurysms of them,including 1 false negative and 4 false positive.For detecting tiny aneurysms,the sensitivity,specificity,accuracy of 64-CTA were once 91.8%、86.0%、91.5% respectively.There was no significant difference between 64-CTA and DSA for detecting the intracranial small aneurysms and tiny aneurysms（P〉0.05）.Conclusion 64-CTA can greatly improve the capability of detecting the intracranial small aneurysms,and can be the first modality choice for screening the intracranial small aneurysms.