减影CTA成像技术在颅内动脉瘤诊断中的应用

目的:探讨64排螺旋CT减影CTA成像技术对颅内动脉瘤的诊断作用。方法:对120例临床蛛网膜下腔出血的病人行CT检查,重建技术用最大密度投影(MIP)和容积再现(VR)。以手术及部分数字减影血管造影术(digital subtraction angiography,DSA)为标准评价减影CTA和常规CTA检查结果,采用双盲法评价图像质量。结果:减影CTA检出动脉瘤122个,敏感性为100%,特异性为100%,阴性似然比为0.000 0;常规CTA检出动脉瘤119个,漏检3个颈内动脉床突下的动脉瘤,敏感性为97.5%,特异性为100%,阴性似然比为0.025 0。结论:减影CTA技术对颈内动脉床突下动脉瘤的检出具有明显的优势。

Advantages of 64-row computed tomography subtraction angiography in the diagnosis of intracranial aneurysms

Objective: To evaluate the advantages of 64-row computed tomography subtraction CT angiography in the diagnosis of intracranial aneurysms.Methods: One hundred and twenty patients who suffered from subarachnoid hemorrhage received CT examination;the CTA and subtraction CT angiography techniques were used to evaluate the cerebral arteries,respectively.Two senior neurosurgical and radiological doctors reviewed both types of the reconstructive results independently.Results: By the subtraction CT angiography technique,122 intracranial aneurysm were detected in 120 cases.Its sensitivity,specificity and negative likelihood ratio for detecting aneurysms on CTA were both 100% and 0.0000 respectively;however the CTA technique indicated 119 lesions and 3 were missed in processus clinoideus anterior of internal carotid,its sensitivity,specificity and negative likelihood ratio were 97.5%,100% and 0.025 0 respectively.Conclusion: Subtraction CT angiography technique have marked advantage in detecting the aneurysm of processus clinoideus anterior of internal carotid.