双源Flash扫描模式CTA结合迭代重建诊断脑血管病变

目的探讨第二代双源Flash扫描模式CTA结合迭代重建诊断脑血管病变的临床应用价值。方法回顾性分析105例接受双源Flash扫描模式结合迭代重建脑血管CTA的疑诊脑血管病变患者的资料。以3D-DSA为金标准,计算Flash扫描模式CTA诊断脑血管病变的敏感度、特异度、阳性预测值、阴性预测值及准确率。比较3D-DSA与Flash扫描模式CTA诊断脑血管病变的差异,计算双源Flash扫描模式CTA的辐射剂量及对比剂用量。结果 105例中,Flash扫描模式CTA诊断60例共73个脑动脉瘤,其中微小动脉瘤24个;诊断13例脉动静脉畸形(AVM);检出颈内动脉海绵窦瘘5例、静脉畸形2例,脑动脉狭窄9例,烟雾病6例。以3D-DSA为金标准,CTA误诊微小动脉瘤2例,漏诊1例位于大脑中动脉远端区域的AVM。Flash扫描模式CTA诊断脑血管病变的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为98.94%(93/94)、81.82%(9/11)、97.89%(93/95)、90.00%(9/10)和97.14%(102/105),辐射剂量为(231.9±13.2)mGy·cm,对比剂用量为(49.32±2.54)ml。结论脑部Flash扫描模式CTA结合迭代重建可快速、准确诊断脑血管病变,同时辐射剂量低、对比剂用量少。

Dual-source Flash scanning model CTA combined iterative reconstruction in diagnosis ofcerebrovascular lesions

Objective To explore the clinical application value of the second generation dual-source Flash scanning model CTA combined iterative reconstruction in diagnosis of cerebrovascular lesions. Methods Data of 105 patients with suspected cerebrovascular lesions who underwent dual-source Flash scanning model CTA combined iteration reconstruction for cerebral vessels were analyzed retrospectively. Taken 3D-DSA as the gold standards, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the Flash scanning model CTA in diagnosis of cerebrovascular lesions were calculated. The differences between 3D-DSA and Flash scanning model CTA in diagnosis of cerebrovascular lesions were compared. Flash CTA radiation dose and contrast agent dosage were calculated. Results Among 105 patients, dual-source Flash scanning model CTA diagnosed 73 aneurysms in 60 cases, including 24 micro aneurysms, as well as 13 cases of arteriovenous malformation (AVM), 5 cases of internal carotid cavernous sinus leakage, 2 cases of venous malformation, 9 cases of arterial stenosis and 6 cases of moyamoya disease, while misdiagnosed 2 cases of micro aneurysms and missed 1 case of AVM located in distal area of middle cerebral artery. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Flash scanning model CTA in diagnosis of cerebrovascular lesions was 98.94% (93/94), 81.82% (9/11), 97.89% (93/95), 90.00% (9/10)and 97.14% (102/105), respectively. CTA radiation dose in Flash scan mode was (231.9±13.2)mGy·cm,and the contrast agent dosage was (49.32±2.54)ml. Conclusion Flash scanning model CTA combined iterative reconstruction was rapid and accurate in diagnosis of brain lesions with low radiation dose and low contrast agent dosage.