选择性能谱纯化技术双能CT血管造影在诊断颅内动脉瘤中的应用价值

目的探讨具有选择性能谱纯化技术（SPS）的双能量扫描技术（DE）在CT血管造影（CTA）诊断颅内动脉瘤中的应用价值。方法对70例临床怀疑颅内动脉瘤的患者先后行CTA和三维数字减影血管造影（3D-DSA）检查，CT扫描采用SPS-DE技术，对SPS-DE-CTA的图像质量进行主观评分，对两种方法显示的动脉瘤部位、数目、瘤颈显示程度以及瘤长径、短径和瘤颈宽度进行对比研究。结果SPS-DE．CTA的图像质量均在4分以上，能满足诊断要求；以3D-DSA为诊断标准，SPS-DE-CTA检测动脉瘤的敏感度、特异度、阳性预测值、阴性预测值和准确度均为100％。SPS-DE-CTA共检出63个动脉瘤，瘤长径、短径和瘤颈宽度分别为（4．96±1．47）mm、（4．01±1．59）mm和（3．02±0．75）mm。3D-DSA共检出63个动脉瘤，瘤长径、短径和瘤颈宽度分别为（4．89±1．52）ml／l、（3．89±1．56）mm和（2．91±0．73）ram。以313．DSA为诊断标准，两种检查方法所得动脉瘤部位、数目及测量数据比较，差异均无统计学意义（P〉0．05），且两种检查方法测得的瘤长径（r=0．963）、瘤短径（r=0．968）和瘤颈宽度（r=0．856）有很好的相关性（P：0．000）。结论SPS-DE-CTA诊断颅内动脉瘤有较高的诊断准确性，可作为一种无创性的常规筛查方法。

Application value of dual energy scan technique with selective photon shield for computed tomography angiography diagnosis of intracranial aneurysms

Objective To investigate the clinical value of dual energy （DE） scan technique with selective photon shield （SPS） for the CT angiography （CTA） diagnosis of intracranial aneurysms. Methods Seventy patients with clinically suspected intracranial aneurysms were examined by the CTA and three dimensional digital subtraction angiography （3D-DSA） one week later. SPS-DE technology was used for CT scanning and the image quality of SPS-DE-CTA was subjective rated. The locations and numbers of aneurysm, display degree of aneurysmal neck, long and short diameters of aneurysm, and sizes of aneurysmal neck indicated by two methods were compared and analyzed. Results The image quality of SPS-DE-CTA was over 4 scores, which could satisfy the diagnostic requirements. The 3D-DSA was referred to as the diagnostic standard and the sensitivity, specificity, prediction values of the posidve and negative, and accuracy of detecting aneurysms by the SPS-DE- CTA were 100%. And 63 aneurysms were detected by the SPS-DE-CTA and the mean long diameter, short diameter, and sizes of aneurysmal neck were （4.96 ±1.47） mm, （4.01 ±1.59） ram, and （3.02 ±0.75） ram, respectively. The 3D-DSA also detected 63 aneurysms and the mean long diameter, short diameter, and sizes of aneurysmal neck were （4.89±1.52） mm, （3.89 ±1.56） mm, and （2.91 ±0.73） ram, respectively. With 3D- DSA as the diagnostic standard, the differences of locations and numbers of aneurysms and measurements of twodiagnostic methods were not statistically significant （P〉0.05）. The mean long diameter （r =0. 963）, short diameter （r =0. 968） of aneurysm, and mean size of aneurysmal neck （ r =0. 856） measured by two diagnostic methods were well correlated （P = 0. 000）. Conclusion The accuracy of SPS-DE-CTA for diagnosing intracranial aneurysms is high and can be used as a routine non-invasive screening method.