CTA、MRA分别联合MMP-9、Caspase-3对颅内动脉瘤的诊断价值

目的分析脑动脉CT血管成像(CT angiography,CTA)、磁共振血管成像(Magnetic resonance angiography,MRA)分别联合血清基质金属蛋白酶9(matrix metalloproteinase 9,MMP-9)、天冬氨酸特异性半胱氨酸蛋白酶3(Caspase-3)在颅内动脉瘤诊断中的应用价值。方法选取上海市第一人民医院收治的86例疑似颅内动脉瘤患者,术前常规检查血清MMP-9、Caspase-3水平,并行CTA与MRA诊断,以手术病理为"金标准",比较CTA、MRA分别联合血清MMP-9、Caspase-3诊断准确性、特异度、灵敏度,观察2种联合诊断方式对动脉瘤分布的检查情况。结果CTA联合血清MMP-9、Caspase-3诊断颅内动脉瘤灵敏度97.37%,特异度90.00%,准确性96.51%,Kappa值0.84;MRA联合血清MMP-9、Caspase-3诊断灵敏度85.53%,特异度70.00%,准确性83.72%,Kappa值0.41;CTA联合血清MMP-9、Caspase-3诊断灵敏度、准确性显著高于MRA联合血清MMP-9、Caspase-3(P<0.05),且在诊断动脉瘤分布情况方面优于MRA联合血清MMP-9、Caspase-3。结论与MRA相比,CTA联合血清MMP-9、Caspase-3对颅内动脉瘤诊断灵敏度、准确性更高,CTA在动脉瘤分布情况显示方面具有更大优势。

Value of CTA and MRA Respectively Combined with Serum MMP-9 and Caspase-3 in the Diagnosis of Intracranial Aneurysms

Objective To analyze the application value of CT angiography(CTA) and magnetic resonance angiography(MRA) respectively combined with serum matrix metalloproteinase-9(MMP-9) and Caspase-3 in the diagnosis of intracranial aneurysms. Methods Eighty-six patients with suspected intracranial aneurysms in Shanghai First People’s Hospital were selected as subjects. The levels of serum MMP-9 and Caspase-3 were routinely examined before operation. The diagnosis of CTA and MRA was performed. With surgical pathology as the golden standard. The diagnostic accuracy, specificity and sensitivity were compared between CTA and MRA respectively combined with serum MMP-9 and Caspase-3. The distribution of aneurysms examined by the two combined diagnostic methods was observed. Results The sensitivity, specificity, accuracy and Kappa value of CTA combined with serum MMP-9 and Caspase-3 in the diagnosis of intracranial aneurysms were 97.37%, 90.00%, 96.51% and 0.84 while those of MRA combined with serum MMP-9 and Caspase-3 were 85.53%, 70.00%, 83.72% and 0.41. The sensitivity and accuracy of CTA combined with serum MMP-9 and Caspase-3 were significantly higher than those of MRA combined with serum MMP-9 and Caspase-3(P<0.05). For diagnosis of the distribution of aneurysms, CTA combined with serum MMP-9 and Caspase-3 was superior to MRA combined with serum MMP-9 and Caspase-3. Conclusion Compared with MRA, the sensitivity and accuracy of CTA combined with serum MMP-9 and Caspase-3 are higher in the diagnosis of intracranial aneurysms, CTA has more advantages in display of the distribution of aneurysms.