3D-螺旋CT血管造影与3D-数字减影血管造影对颅内动脉瘤影像诊断的比较研究

目的比较3D-螺旋CT血管造影（3D-CTA）和3D-数字减影血管造影（3D-DSA）在颅内动脉瘤诊断中的应用价值。方法对天津市环湖医院2004年1月至2005年3月就诊的自发性蛛网膜下腔出血（SAH）患者86例，行3D—CTA、3D—DSA检查。研究并比较CTA和DSA影像特点。结果86例患者，阴性12例，余74例患者共检出94个动脉瘤。3D—DSA与3D—CTA准确性比较，差异无统计学意义。结论动脉瘤应用血管内栓塞治疗时，在3D影像指导下可提高动脉瘤的致密填塞率。但是在3D影像的测量值要大于2D影像的测量值。

3-dimension computed tomography angiography and digital subtraction angiography in diagnosis of intracranial aneurysm: a comparative study

OBJECTIVE: To compare the appliance values off 3-dimension computed tomography (CTA) and digital subtraction angiography (DSA) in diagnosis of intracranial aneurysm (ICA). METHODS: Eighty-six with subarachnoid hemorrhage underwent 2-D DSA, and 3-DCTA and 3-D DSA, both including maximum intensity projection (MIP) and multiple planner reconstruction (MPR), volume rending (VR). The accuracy, misdiagnosis rate, and missed diagnosis rate of these 3 techniques were compared. No significant complication was found. RESULTS: Ninety-four aneurysms were found in 74 patients. CTA examination obtained satisfactory MPR, MIP, and VR images in all patients. There was no significant difference in accuracy between 3D-DSA and 3D-CTA. In display of the aneurysm 3D-CTA was not significantly different from 2D-DSA in most cases. In display of the neck of aneurysm 3D-CTA was not significantly different from 3D-DSA, and these 3 techniques were both superior to 2D-DSA. CONCLUSION: 3D-CTA is the first choice examination technique for patients with subarachnoid hemorrhage. The information obtained by 2D-DSA, 3D-DSA, and 3D-CTA should be considered comprehensively.