CTA、MRA及DSA在脑血管疾病患者临床诊断中的意义

目的 研究比较CTA、MRA及DSA检查在脑血管疾病临床诊断中的意义.方法 选取2000年2月-2012年3月入住我院神经内科疑似脑血管疾病（CVD）的患者98例,依次进行MRA、CTA及DSA检查,统计、比较3种检查方法对患者脑动脉瘤和动静脉畸形的检出部位和敏感性情况.结果 本组患者经MRA检查发现动脉瘤47例,经CTA检查发现动脉瘤48例,经DSA检查发现动脉瘤49例,最后经3种方法联合检查确诊动脉瘤47例,共50个瘤体,其中44例为单发状态,另3例均含2个瘤体.经MRA检查发现动静脉畸形24例,经CTA检查发现动静脉畸形23例,经DSA检查发现动静脉畸形25例,最后经3种方法联合检查确诊动静脉畸形25例.3种检查方法对脑动脉瘤和动静脉畸形的敏感性、特异性比较差异均无统计学意义（均P＞0.05）.结论 MRA无需使用造影剂,不含电离辐射,且具有无创性,可作为CVD诊断的首选无创方案.若需进一步提升诊断检出率,则可采用联合方案.

Significance of clinical diagnosis with CTA,MRA and DSA in patients with cerebrovascular disease

Objective To study and compare significance of clinical diagnosis with CTA, MRA,and DSA in patients with cerebrovascular disease. Methods Chose from February 2000 to March 2012,98 cases of hospital patients with suspected CVD. All patients followed in proper sequence of MRA,CTA and DSA examination, did statistics and com- pare the three groups of cerebral aneurysms and arteriovenous malformations＇ detection position and sensitivity condi- tion. Results All patients by MRA examination revealed 47 cases of aneurysms, by CTA examination revealed 48 ca- ses,by DSA examination revealed 49 cases. And finally by the three kinds of joint examination revealed 47 cases diag- nosed with aneurysm,a total of 50 tumors,of which 44 cases were single state,and the other three cases are inclusive of two tumors. By MRA examination revealed 24 cases with arteriovenous malformations, by CTA examination revealed 23 cases, by ISA examination revealed 25 cases. And finally by the three kinds of joint examination revealed 25 patients di- agnosed with arteriovenous malformations. Comparison of three methods for the diagnosis of cerebral aneurysms and ar- teriovenous malformations sensitive, specificity situation, and the differences was not statistically significant （all P 0.05）. Conclusion MRA without contrast agent, ionizing radiation and non-invasive, has very important application value in the clinical, can be preferred noninvasive diagnostic program for CVD. For further enhance the diagnostic detec- tion rate,may use joint program.