64层螺旋CT数字减影脑血管成像在烟雾病诊断中的价值

目的 探讨数字减影CT血管成像(DSCTA)在烟雾病诊断中的价值.方法 回顾性分析54例临床及影像资料确诊为烟雾病患者的脑血管CTA资料,分别用减影法及非减影法CTA对原始扫描数据行后处理,运用X~2检验比较两种方法对颈内动脉(ICA)终末段、大脑前动脉(ACA)及大脑中动脉(MCA)起始段狭窄或者闭塞的检出率,以及颅底异常血管网和椎-基底动脉系统代偿性扩张的显示情况等有无差异,同时评价DSCTA重组图像质量.采用t检验比较DSCTA与常规CTA在后处理时间上是否有差异.结果 DSCTA重组图像的质量均能满足颅内血管病变的显示.DSCTA和常规CTA分别显示46例和32例ICA终末段病变,两者间差异有统计学意义(X~2=9.05,P＜0.01).DSCTA分别显示48例ACA起始段病变、52例MCA起始段病变、38例颅底异常血管网和17例椎-基底动脉系统代偿性扩张,常规CTA则分别显示41、47、34和13例,两种方法间差异无统计学意义(P＞0.05).DSCTA和常规CTA后处理平均时间分别为(8.5±2.5)和(14.5±2.0)min,两者间差异有统计学意义(t=13.77,P＜0.01).结论 DSCTA是一种快速、易行和可靠的CTA技术,有利于烟雾病患者ICA终末端病变的检出,为该病提供了一种安全、准确的诊断方法.

Evaluation of 64-slice spiral digital subtraction CT angiography in the diagnosis of Moyamoya disease

Objective To evaluate the diagnostic value of digital subtraction CT angiography (DSCTA) in Moyamoya disease.Methods The cerebral vascular CTA data of 54 patients with Moyamoya disease were analyzed retrospectively. All the original data were processed with non-subtraction and subtraction method.Student t-test was used to compare the post-processing time difference between DSCTA and routine CTA. Chi-square test was used to compare the differences between the detection rates of the stenosis or occlusion in the internal carotid artery (ICA) terminal,the initials of anterior cerebial artery (ACA) and middle cerebral artery (MCA),abnormal vascular network at skull base,and compensatory enlargement of vertebral-basilar artery system.The quality of DSCTA images was also evaluated.Results The quality of DSCTA images could meet the needs of demonstrating intracranial vascular lesions.DSCTA and conventional CTA imaging demonstrated 46 lesions and 32 lesions in ICA terminal,respectively.There was significant difference between the two methods (X~2=9.05 ,P＜ 0.01).Forty-eight ACA initial lesions,52 MCA initial lesions,38 cases with abnormal vascular network at skull base and 17 cases with compensatory enlargement of vertebral-basilar artery system were detected on DSCTA images,while 41,47,34 and 13 cases were detected on conventional CTA,respectively.No difference was found between the two groups (P ＞0.05).The post-processing time was (8.5±2.5)min for DSCTA,which was significantly less than that in conventional CTA (14.5±2.0) min](t=13.77,P＜0.01).Conclusion DSCTA is a fast,easy and reliable CTA technology,which can improve the demonstration of ICA terminal lesions in patients with Moyamoya disease,and it can be used as a safe and accurate diagnostic method for the diagnosis of Moyamoya disease.