头颈部CT血管成像对颅内动脉瘤的诊断价值更高

  目的  探究头颈部CT血管成像（CTA）在颅内动脉瘤中的诊断效果及在手术指导中的应用价值。  方法  选择2018年6月~ 2021年9月本院收治的129例颅内动脉瘤疑似患者纳入研究对象，均行头颈部CTA诊断和磁共振血管成像（MRA）诊断，以数字减影血管造影（DSA）作为金标准，比较头颈部CTA诊断和MRA诊断对颅内动脉瘤的诊断及手术应用价值。  结果  以DSA诊断为“金标准”，129例颅内动脉瘤疑似患者经DSA诊断证实有80例确诊为颅内动脉瘤，头颈部CTA诊断准确度为92.24%，敏感度为95.06%，特异性为87.50%，阳性预测值为92.77%，阴性预测值为91.30%；MRA诊断准确度为88.37%，敏感度为91.46%，特异性为82.97%，阳性预测值为90.36%，阴性预测值为84.78%。头颈部CTA诊断和MRA诊断的病灶检出部位差异无统计学意义（P>0.05）。头颈部CTA诊断检出 < 3 mm直径的瘤体数量多于MRA诊断（P < 0.05）。头颈部CTA诊断Kappa值为0.850，MRA诊断的Kappa值为0.747，头颈部CTA诊断与DSA诊断一致性更高。  结论  头颈部CT血管成像对颅内动脉瘤的诊断价值更高，对手术治疗具有更好的指导作用。 

Head and neck CT angiography has higher diagnostic and value for intracranial aneurysms

  Objective  To explore the diagnostic efficiency of head and neck computerized tomography angiography (CTA) for intracranial aneurysms and its application value in surgical guidance.  Methods  A total of 129 patients with suspected intracranial aneurysms admitted to the hospital were enrolled as the research objects from June 2018 to September 2021. All patients underwent head and neck CTA and magnetic resonance angiography (MRA). Taking digital subtraction angiography (DSA) as the golden standard, application value of head and neck CTA and MRA in the diagnosis and surgical guidance of intracranial aneurysms was compared.  Results  Taking DSA diagnosis as the golden standard, there were 80 cases confirmed with intracranial aneurysms in the 129 patients. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of head and neck CTA and MRA were 92.24%, 95.06%, 87.50%, 92.77%, 91.30% and 88.37%, 91.46%, 82.97%, 90.36%, 84.78%, respectively. There was no significant difference in detection sites of lesions between head and neck CTA and MRA (P > 0.05). The number of tumors with diameter < 3 mm by head and neck CTA was more than that by MRA (P < 0.05). The Kappa values of head and neck CTA and MRA were 0.850 and 0.747, respectively. The diagnosis consistency between head and neck CTA and DSA was higher.  Conclusion  The diagnostic value of head and neck CTA is higher for intracranial aneurysms, which is of better guidance roles in surgical treatment.