自发性蛛网膜下腔出血的CTA与DSA对比研究

目的:探讨64层CTA与DSA对自发性蛛网膜下腔出血(spontaneous subarachnoid hemorrhage,s-SAH)的应用价值及其限度。方法:收集153例s-SAH患者的CTA及DSA检查资料,回顾性分析2种检查方法的图像质量(采取1³分评分制),并比较2种方法在脑动脉瘤检出方面的灵敏度、特异度及准确度。结果:图像质量评分CTA为(2.63±0.262)分,DSA为(2.73±0.254)分,二者差异无统计学意义(P>0.05)。CTA对脑动脉瘤的检出的灵敏度为96.2%,特异度为94.9%,准确度为95.9%;DSA灵敏度为97.7%,特异度为97.4%,准确度为97.6%,二者差异无统计学意义(P>0.05)。结论:在s-SAH患者中,CTA与DSA均能准确检出动脉瘤所致破裂出血。相较于DSA,CTA能多方位显示病变,对血管壁及血管周围情况的显示更具价值。

Comparative study of 64-slice CT angiography and digital subtraction angiography in spontaneous subarachnoid hemorrhage cases

Objective： To investigate the diagnosis value and its limitation of 64-slice CT angiography and digital subtraction angiography in spontaneous subarachnoid（s-SAH）cases. Methods： 153 patients with s-SAH underwent 64-slice CTA and DSA,image quality were graded（scale：1-3）and compared between two different angiographies. For brain aneurysm detection, CTA and DSA were compared by sensitivity,accuracy and specific degrees. Results：There was no significant difference between CTA and DSA with sensitivity, accuracy, specific degrees,and image quMity（P〉0.05）. The image quality of CTA and DSA was（2.63 ±0.62）, （2.73±0.54）respectively. The sensitivity,accuracy,specific degrees for brain aneurysm detection of CTA and DSA were 96.2%,94.9%,95.9% and 97.7%,97.4%,97.6%. Conclusion：Both CTA and DSA can accurately detect s-SAH cases caused by aneurysm rupture. CTA can display the size,the neck and axis direction of the detected aneurysms,and it is more valuable in displaying vessel wall or situation surrounding vessels.