颅内破裂动脉瘤的三维和二维血管造影的形态学差异

目的 研究颅内动脉瘤在3D-DSA容积图像上(volume rendering,VR)和常规2D-DSA平面图像上的形态学诊断差异.方法 在三维和两维图像上分别测量了45个颅内动脉瘤的最长径、横径和瘤颈宽度,并按照动脉瘤的大小和部位,比较两种成像技术的各项测量结果.结果 3D-DSA容积图像上所测量的颅内动脉瘤大小比2D-DSA平面图像要大,特别是位于大脑前动脉和直径小于10 mm的颅内动脉瘤.结论 3D-DSA图像上所测得的各项数据平均值都较2D-DSA为大.45例动脉瘤中,3D-DSA图像上有38例(84%)最长径大于2D-DSA,37例(82%)最大横径大于2D-DSA,41例(91%)瘤颈宽度大于2D-DSA.直径＜5 mm的动脉瘤最大横径(P=0.014)和瘤颈宽度(P=0.015)存在明显差别;直径＞10 mm的动脉瘤各项测量结果不存在差异;直径介于5～10 mm之间的动脉瘤各项测量差别均存在显著性.位于大脑前动脉的动脉瘤最大横径(P=0.011)和瘤颈宽度(P=0.006)差别存在显著性;分布于颈内动脉、大脑中动脉和后循环区域的动脉瘤差别无显著性.

Discrimination on the aneurysms between morphological depiction of ruptured intracranial three-dimensional and two-dimensional digital subtraction angiography

Objective To explore the morphological discrepancy of ruptured intracranial aneurysms on both three-dimensional digital subtraction angiography(3D-DSA,volume-rendering imaging) and two-dimensional digital subtraction angiography(2D-DSA),particularly focusing on the size and location of aneurysms as depicted in both images.Methods 45 aneurysms were depicted on either 3D-DSA or 2D-DSA images.The sizes of each aneurysm,including maximal longitudinal,transverse diameter and width of neck,were compared between two imaging techniques.For comparison of size and location of aneurysm,statistical analysis were performed with the Paired-Sample T Test.Results 38(84%) of the 45 aneurysms in maximal longitudinal distance,37(82%) in transverse diameter and 41(91%) in the width of neck were larger when measured with 3D-DSA than with 2D-DSA.There were statistical significances on the comparison of the aneurysms of size<10 mm in transverse diameter(P=0.014) and width of neck(P=0.015) between 3D-DSA and 2D-DSA detection approximately,while those of size>10 mm didn't share the same differences.In ACA territories,sizes of the aneurysms were bigger when measured with 3D-DSA(maximal transverse diameter,P=0.011;width of neck,P=0.006,respectively) than with 2D-DSA.In MCA as well as those located in the posterior circulation,aneurysms' sizes were comparative between 3D-DSA and 2D-DSA measurements.Conclusion 3D-DSA,volume-rendering images,tends to depict ruptured intracranial aneurysms bigger than 2D-DSA.This is particularly remarkable with intracranial aneurysms that are <10 mm in size and are located in ACA territories.