3D-CTA对颅内动脉瘤诊断效能及治疗指导的价值研究

目的探究三维CT血管造影(3D-CTA)对颅内动脉瘤诊断效能及治疗指导的价值。方法回顾性分析因蛛网膜下腔出血入院且均接受3D-CTA检查与三维数字减影血管造影(3D-DSA)检查的208例患者临床资料,以3D-DSA检查结果为"金标准"评价3D-CTA在颅内动脉瘤中的诊断效能及在治疗指导中的价值。结果 212例患者经3D-DSA检查,9例患者未检出动脉瘤,203例患者中检出动脉瘤251个;3D-CTA检查,17例未检出动脉瘤,195例患者中检出动脉瘤243个,诊断效能:灵敏度95.57%,特异度88.89%,准确率95.28%,阳性预测值99.49%,阴性预测值47.06%。3D-CTA诊断后交通动脉、前交通动脉、颈内动脉颅内段、基底动脉诊断符合率为96.05%、97.01%、89.66%、80.00%,其余部位符合率均为100.0 0%。3D-CTA和3D-DSA检查动脉瘤的瘤体最大径和瘤体颈宽比较差异均无统计学意义(P>0.05)。203例手术治疗患者中169例术后采用3D-CTA复查,均能清晰显示动脉瘤夹位置与数目,患者术后动脉瘤完全闭塞,瘤颈无残留。结论 3D-CTA在颅内动脉瘤诊断中具有较高诊断效能,可提供影像学信息指导临床治疗及术后评价。

Study on Diagnostic Efficacy of 3D-CTA on Intracranial Aneurysms and Value of Treatment Guidance

Objective To explore the value of three-dimensional CT angiography(3D-CTA)in the diagnosis and treatment guidance of intracranial aneurysms.Methods The clinical data of 208 patients admitted to the hospital for subarachnoid hemorrhage and received 3D-CTA and 3D-DSA were retrospectively analyzed.The 3D-DSA results were used as the gold standards to evaluate the diagnostic efficacy of 3D-CTA on intracranial aneurysms and value in treatment guidance.Results Among 212 patients examined by 3D-DSA,9 patients did not detect aneurysms and 203 patients detected 251 aneurysms.By 3D-CTA,17 patients did not detect aneurysms and 195 patients detected 243 aneurysms.Diagnostic efficiency showed the sensitivity,specificity,accuracy rate,positive predictive value,and negative predictive value were 95.57%,88.89%,95.28%,99.49%,and 47.06%.The diagnostic coincidence rates of 3D-CTA in the diagnosis of the posterior communicating artery,anterior communicating artery,an intracranial segment of the internal carotid artery,and basilar artery were 96.05%,97.01%,89.66%,and 80.00%,and the coincidence rates of the other parts all were 100.00%.There were no statistically significant differences in the maximum tumor diameter and tumor neck width of aneurysms between 3D-CTA and 3D-DSA(P>0.05).169 patients among 203 surgically treated patients were reviewed by 3D-CTA after surgery,all of which clearly showed the position and quantity of aneurysm clips,and the patients had complete occlusion of the aneurysm without residual in tumor neck.Conclusion 3D-CTA has high diagnostic efficacy in diagnosing intracranial aneurysms and can provide imaging information to guide clinical treatment and postoperative evaluation.