CTA与高分辨磁共振血管壁成像评估颅内动脉瘤破裂风险的临床价值

目的 探讨CT血管造影(CTA)与高分辨磁共振血管壁成像(HR-MRI)评估颅内动脉瘤破裂风险的临床价值.方法 选取2019年1月至2020年12月我院收治的189例颅内动脉瘤患者作为研究对象,入院后均行数字减影血管造影(DSA)、CTA、HR-MRI检查,检测患者动脉瘤破裂情况,并根据诊断结果将患者分为破裂组(n=5...

Clinical value of CTA and high-resolution magnetic resonance imaging in assessing the risk of intracranial aneurysm rupture

Objective To explore the clinical value of CT angiography(CTA) and high-resolution magnetic resonance imaging(HR-MRI) in assessing the risk of intracranial aneurysm rupture.Methods One hundred and eighty-nine patients with intracranial aneurysms treated in our hospital from January 2019 to December 2020 were selected as the research objects.After admission,the patients were examined by digital subtraction angiography(DSA),CTA and HR-MRI;the ruptured aneurysm was detected,and the patients were divided into ruptured group(n=55) and non-ruptured group(n=134)according to the diagnostic results.The imaging parameters of different inspection methods were compared between the two groups,and the receiver operating characteristic curve(ROC) was used to evaluate the predictive value of CTA and HR-MRI.Results CTA parameters such as tumor body length,tumor neck width,aneurysm inclination angle,ascus,AR,SR and area ratio in the ruptured group were significantly higher than those in the non-ruptured group(P<0.05);HR-MRI parameters such as tumor body length,tumor neck width,ascus,enhancement,AR and SR in the ruptured group were significantly higher than those in the non-ruptured group(P<0.05);ROC curve showed that the area under the curve(AUC) predicted by CTA parameters such as tumor body length,tumor neck width,aneurysm inclination angle,ascus,AR,SR and area ratio were 0.786,0.714,0.832,0.690,0.666,0.797 and 0.796,respectively;tumor body length,tumor neck width,SR and area ratio had high specificity but low sensitivity in predicting intracranial aneurysm;AR had high sensitivity and low specificity in predicting intracranial aneurysm;the specificity and sensitivity of aneurysm inclination angle and ascus in predicting intracranial aneurysm were high.The AUC of ruptured internal carotid aneurysm predicted by HR-MRI parameters such as tumor body length,tumor neck width,ascus,enhancement,AR and SR were 0.763,0.714,0.703,0.896,0.668 and 0.798,respectively.The specificity of tumor body length,tumor neck width and SR in predicting intracranial aneurysm rupture was high,but the sensitivity was low;AR had high sensitivity and low specificity in predicting intracranial aneurysm;the specificity and sensitivity of ascus and enhancement in predicting intracranial aneurysm were high.Conclusion There are significant differences in CTA and HR-MRI parameters in patients with or without ruptured intracranial aneurysm.CTA and HR-MRI have certain accuracy in predicting the risk of ruptured intracranial aneurysm,but there are certain false positives and missed diagnosis.