MSCTA三维重建诊断颅内动脉瘤与DSA的一致性研究

目的探讨多层螺旋CT血管成像(MSCTA)三维重建技术与数字减影血管造影(DSA)在诊断颅内动脉瘤的一致性。方法收集2017年6月至2018年12月于我院收治的疑似颅内动脉瘤患者96例,同期行MSCTA三维重建检查及DSA检查,以DSA为金标准,计算MSCTA诊断效能,比较两种检查方式检出瘤体形态的差异、空间关系显示差异及图像质量。结果DSA检出颅内动脉瘤患者62例,共有瘤体63个;MSCTA检出颅内动脉瘤者56例,瘤体共60个;以DSA为金标准,MSCTA诊断颅内动脉瘤灵敏度88.74%,特异度97.06%,准确性91.67%,阳性预测值98.21%,阴性预测值82.50%,kappa值为0.825;两种检查方式在瘤体直径与瘤体宽度中的检查结果均无统计学意义(P>0.05);MSCTA三维重建技术可清晰显示动脉瘤钙化、瘤颈走向、载瘤动脉、周边血管关系等空间关系;DSA可显示血流方向、细小动静脉。结论MSCTA三维重建诊断颅内动脉瘤结果与DSA具有良好一致性,且相对无创、经济、简便,可作为颅内动脉瘤诊断的首选方法。

Consistency of MSCTA Three-dimensional Reconstruction and DSA in the Diagnosis of Intracranial Aneurysms

Objective To explore the consistency of multi-slice spiral CT angiography(MSCTA) three-dimensional reconstruction technique and digital subtraction angiography(DSA) in the diagnosis of intracranial aneurysms. Methods A total of 96 patients with suspected intracranial aneurysms admitted to our hospital from June 2017 to December 2018 were collected. MSCTA three-dimensional reconstruction and DSA were performed at the same period. DSA was used as the gold standard to calculate the diagnostic efficacy of MSCTA. The differences of detected tumor morphology, differences of spatial relationship display and image quality were compared between the two examination methods. Results A total of 62 patients with intracranial aneurysms were detected by DSA, with 63 tumors. A total of 56 patients with intracranial aneurysms were detected by MSCTA, with 60 tumors. Taking DSA as the gold standard, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and kappa value of MSCTA in the diagnosis of intracranial aneurysms were 88.74%, 97.06%, 91.67%, 98.21%, 82.50% and 0.825. There were no statistically significant differences between the two examination methods in the examination results of tumor diameter and tumor width(P>0.05). MSCTA three-dimensional reconstruction technology could clearly show the spatial relationships of aneurysm calcification, tumor neck trend, tumor-bearing artery and peripheral blood vessels. DSA could show blood flow direction, small arteries and veins. Conclusion MSCTA three-dimensional reconstruction has good consistency with DSA in the diagnostic results of intracranial aneurysms, and it is relatively noninvasive, economical and simple, and it can be used as the first choice for the diagnosis of intracranial aneurysms.