256排双源CTA与3D-DSA对颅内小动脉瘤的对比分析及临床意义
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摘要
目的对比分析双源CTA与3D-DSA对颅内小动脉瘤的检出率及临床价值。方法回顾性分析本院2015年7月-2017年12月65例疑似颅内小动脉瘤患者,对其双源CTA和DSA检查资料进行对比分析,记录小动脉瘤发生的位置、大小、数目及瘤颈宽度,并分析双源CTA诊断颅内小动脉瘤的敏感度、特异度及约登指数。结果 32例确诊为小动脉瘤患者中,双源CTA诊断出31例患者35枚小动脉瘤,其中34枚动脉瘤检出结果与DSA一致,CTA检出动脉瘤情况与DSA不存在显著差异(P>0.05),无统计学意义。CTA与DSA检出动脉瘤的位置、大小、数目及瘤颈宽度基本相符。结论双源CTA对诊断颅内小动脉瘤具有良好敏感度及特异度,双源CTA相对DSA检查,具有无创、快捷、风险小、费用低的特点,可作为筛查颅内小动脉瘤的首选方法,诊断结论对进一步临床治疗具有重要意义。
Objective To compare the detection rate and clinical value of dual-source CTA and 3 D-DSA for intracranial small aneurysms. Methods Retrospective analysis of 35 cases of suspected intracranial small aneurysms in our hospital from July 2015 to December2017,comparison and analysis of the double-source CTA and DSA examination data,and record the location, size, number and neck width of small aneurysms, to analyze the sensitivity, specificity and YouDen Index of the diagnosis of intracranial small aneurysms.Results 30 patients were confirmed with intracranial small aneurysms, dual source CTA diagnosed 31 small aneurysms in 29 patients, in all aneurysms, the results of 30 aneurysms were consistent with DSA, there was no significant difference between CTA and DSA(P>0.05),no statistical significance. The location, size, number and neck width of the aneurysms were basically consistent with that of DSA. Conclusion Dual-source CTA has good sensitivity and specificity for diagnosing intracranial small aneurysms, to compare with DSA, Dual-source CTA is relatively noninvasive, fast, low risk and low cost, it can be the preferred method for screening intracranial small aneurysms. Diagnosis conclusion is of great significance for further clinical treatment.
Objective To compare the detection rate and clinical value of dual-source CTA and 3 D-DSA for intracranial small aneurysms. Methods Retrospective analysis of 35 cases of suspected intracranial small aneurysms in our hospital from July 2015 to December2017,comparison and analysis of the double-source CTA and DSA examination data,and record the location, size, number and neck width of small aneurysms, to analyze the sensitivity, specificity and YouDen Index of the diagnosis of intracranial small aneurysms.Results 30 patients were confirmed with intracranial small aneurysms, dual source CTA diagnosed 31 small aneurysms in 29 patients, in all aneurysms, the results of 30 aneurysms were consistent with DSA, there was no significant difference between CTA and DSA(P>0.05),no statistical significance. The location, size, number and neck width of the aneurysms were basically consistent with that of DSA. Conclusion Dual-source CTA has good sensitivity and specificity for diagnosing intracranial small aneurysms, to compare with DSA, Dual-source CTA is relatively noninvasive, fast, low risk and low cost, it can be the preferred method for screening intracranial small aneurysms. Diagnosis conclusion is of great significance for further clinical treatment.
引文
[1]倪伟,宋冬雷.颅内未破裂微小动脉瘤的研究进展[J].中国脑血管病杂志,2013,10(1):43-47.
[2]Naggara ON,White PM,Guilber F,et al.Endovascular treatment of intracranial unruptured aneurysms:systernatic review and meta-analysis of the literature o n s a f e t y a n d e f f i c a c y[J].Radiology,2010,256(3):887-897.
[3]游梦星,虞希祥,林永胜,等.三维CT血管造影与平板DSA对颅内动脉瘤诊断价值的对比分析[J].介入放射学杂志,2011,20(9):676-680.
[4]Franklin B,Gasco J,Uribe T,e t al.Diagnastic accuracy and Inter-rater reliability of 64-mutislice 3D-CTAcompared to intra-arterial DSA for interacranial aneurysms[J].Clin Neurosci,2010,17:579-583.
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[8]Shin SH,Kwon SC,Suh DC.Recent update of guidelines for neurointerventional procedures[J].Neurointervention,2013,8(2):68-72.
[9]江国权,方兴根,徐善水,等.颅内动脉瘤破裂的血流动力学和形态学因素[J].介入放射学杂志,2014,23(12):1109-1113.
[10]郑永涛,刘盈君,冷冰.颅内动脉瘤破裂的影响因素[J].国际脑血管病杂志,2014,22(6):464-469.
[11]季卫阳,丁鸭锁,殷力维,等.3D-CTA与3D-DSA在颅内动脉瘤影像诊断中的对比研究[J].中华神经外科杂志,2012,28(5):444-447.
[12]丁娟,孙刚,李敏,等.320排CT低剂量CTA评价颅内动脉瘤的可行性研究[J].中华临床医师杂志,2012,6(8):2217-2220.
[13]周昌龙,夏小辉,贺学农.3D-CTA与3D-DSA诊断颅内动脉瘤对比研究的Meta分析[J].第三军医大学学报,2012,34(19):2027.
[14]程钢戈,朴龙松,董连强,等.旋转数字减影血管造影及三维重建在颅内动脉瘤诊治中的应用[J].解放军医学杂志.2008,33(9):1130-1131.
[15]于军,王壮,赵明明,等.3D-CTA与3 D-D S A对颅内动脉瘤诊断价值比较[J].中华神经外科杂志,2013,29(3):238.
[16]Chen W,Wang J,Xin W,etal.Accuracy of 16-row multislice computed tomographic angiography for assessment of small cerebral aneurysms[J].Neurosurgery,2008,62(1):113-122.
[17]朱青峰,王国芳,周志国.颈动脉穿刺微弹簧圈栓塞术后治疗前交通动脉瘤1例[J].中华神经外科疾病研究杂志,2012,11(3):270-271.
[18]Long-Jiang Zhang,Sheng-Yong Wu,Jing-Bo Niu,et al.Dual-Energy CT Angiography in the Evaluation of Intracranial Aneurysms:Image Quality,Radiation Dose,and Comparison With 3D Rotational Digital Subtraction Angiography[J].AJR,2010,194(1):23-30.
[19]Lu L,Zhang LJ,et al.Digital subtraction CT angiography for detection of intracranial aneurysms:comparison with three-dimensional digital subtraction angiography[J].Radiology,2012,262(2):605-612.
[20]Donmez H,Serifov E,Kahriman G,et al.Comarison of 16-row mutislice CT angiography with conventional angiography for detection and evaluation of intracranial aneurysms[J].EurJRadiol,2011,80(2):455-461.
[21]White PM,Wardlaw JM,Easton V.Can noninvasive imaging accurately depict intracranial aneurysms a systematic review[J].Radiology,2000,217(2):361-370.
[22]Karames s ini M.T,Kagadi s,G.C,Petsas T,et al.CT angiography with three-dimensional techniques for the early diagnosis of intracranial aneurysms.Comparison with intra-arterial DSA and the surgical findings[J].European Journal of Radiology,2004,49(3):212-223.
[23]Yoon,D.Y,Lim,K.J,choi,C.S,et al.Detection and characterization of intracranial aneurysms wih16-channel multidetector row CT angiography:A prospective comparison of volume-rendered images and digital subtraction angiography[J].American Journal of Neurorodiology,2007,28(1):60-67.
[24]郭建新,冒平,牛刚,等.3D-CTA、2D-DSA及3D-DSA对颅内动脉瘤诊断价值的对比研究[J].中国CT和MRI杂志,2011,14(9):28-30.
[25]H.Wang,W.Li,H.He,et al.320-Detector row CT angiography for detection and evaluation of intracranial aneurysms:Comparison with conventional digital subtraction angiography[J].Clinical Radiology,2013,68:e15-e20.
[26]吴永刚,张诚,黄啸元,等.CTA对诊断颅内动脉瘤的临床价值[J].中国CT和MRI杂志,2016,9(5):21-23.
[27]马睿,周存升.CT血管造影对脑动脉瘤的临床应用价值[J].中华放射学杂志,2000,34(7):476-478.
[28]杨显存,刘强,葛彦彦,等.三维重建技术在颅内动脉瘤诊治中的影响因素[J].实用放射学杂志,2013,29(9):1529-1532.
[2]Naggara ON,White PM,Guilber F,et al.Endovascular treatment of intracranial unruptured aneurysms:systernatic review and meta-analysis of the literature o n s a f e t y a n d e f f i c a c y[J].Radiology,2010,256(3):887-897.
[3]游梦星,虞希祥,林永胜,等.三维CT血管造影与平板DSA对颅内动脉瘤诊断价值的对比分析[J].介入放射学杂志,2011,20(9):676-680.
[4]Franklin B,Gasco J,Uribe T,e t al.Diagnastic accuracy and Inter-rater reliability of 64-mutislice 3D-CTAcompared to intra-arterial DSA for interacranial aneurysms[J].Clin Neurosci,2010,17:579-583.
[5]Ramgren B,Siemued R,Nilsson OG,et al.CT angiography in non-traumatic subarachnoid hemorrhage:the importance of arterial attenuation for the detection of intracranial aneurysms[J].Acta Radol,2014,56(10):1248-1255.
[6]Bacigaluppi S,Piccinelli M,Antiga L,et al.Factors affecting formation and rupture of intracranial saccular aneurysms[J].Neurosurg Rev,2014,37(1):1-14.
[7]张建忠,吴曦,黄清海,等.血流动力学诱导炎性反应对颅内动脉瘤形成机制的研究进展[J].中国脑血管病杂志,2014,11(7):381-384.
[8]Shin SH,Kwon SC,Suh DC.Recent update of guidelines for neurointerventional procedures[J].Neurointervention,2013,8(2):68-72.
[9]江国权,方兴根,徐善水,等.颅内动脉瘤破裂的血流动力学和形态学因素[J].介入放射学杂志,2014,23(12):1109-1113.
[10]郑永涛,刘盈君,冷冰.颅内动脉瘤破裂的影响因素[J].国际脑血管病杂志,2014,22(6):464-469.
[11]季卫阳,丁鸭锁,殷力维,等.3D-CTA与3D-DSA在颅内动脉瘤影像诊断中的对比研究[J].中华神经外科杂志,2012,28(5):444-447.
[12]丁娟,孙刚,李敏,等.320排CT低剂量CTA评价颅内动脉瘤的可行性研究[J].中华临床医师杂志,2012,6(8):2217-2220.
[13]周昌龙,夏小辉,贺学农.3D-CTA与3D-DSA诊断颅内动脉瘤对比研究的Meta分析[J].第三军医大学学报,2012,34(19):2027.
[14]程钢戈,朴龙松,董连强,等.旋转数字减影血管造影及三维重建在颅内动脉瘤诊治中的应用[J].解放军医学杂志.2008,33(9):1130-1131.
[15]于军,王壮,赵明明,等.3D-CTA与3 D-D S A对颅内动脉瘤诊断价值比较[J].中华神经外科杂志,2013,29(3):238.
[16]Chen W,Wang J,Xin W,etal.Accuracy of 16-row multislice computed tomographic angiography for assessment of small cerebral aneurysms[J].Neurosurgery,2008,62(1):113-122.
[17]朱青峰,王国芳,周志国.颈动脉穿刺微弹簧圈栓塞术后治疗前交通动脉瘤1例[J].中华神经外科疾病研究杂志,2012,11(3):270-271.
[18]Long-Jiang Zhang,Sheng-Yong Wu,Jing-Bo Niu,et al.Dual-Energy CT Angiography in the Evaluation of Intracranial Aneurysms:Image Quality,Radiation Dose,and Comparison With 3D Rotational Digital Subtraction Angiography[J].AJR,2010,194(1):23-30.
[19]Lu L,Zhang LJ,et al.Digital subtraction CT angiography for detection of intracranial aneurysms:comparison with three-dimensional digital subtraction angiography[J].Radiology,2012,262(2):605-612.
[20]Donmez H,Serifov E,Kahriman G,et al.Comarison of 16-row mutislice CT angiography with conventional angiography for detection and evaluation of intracranial aneurysms[J].EurJRadiol,2011,80(2):455-461.
[21]White PM,Wardlaw JM,Easton V.Can noninvasive imaging accurately depict intracranial aneurysms a systematic review[J].Radiology,2000,217(2):361-370.
[22]Karames s ini M.T,Kagadi s,G.C,Petsas T,et al.CT angiography with three-dimensional techniques for the early diagnosis of intracranial aneurysms.Comparison with intra-arterial DSA and the surgical findings[J].European Journal of Radiology,2004,49(3):212-223.
[23]Yoon,D.Y,Lim,K.J,choi,C.S,et al.Detection and characterization of intracranial aneurysms wih16-channel multidetector row CT angiography:A prospective comparison of volume-rendered images and digital subtraction angiography[J].American Journal of Neurorodiology,2007,28(1):60-67.
[24]郭建新,冒平,牛刚,等.3D-CTA、2D-DSA及3D-DSA对颅内动脉瘤诊断价值的对比研究[J].中国CT和MRI杂志,2011,14(9):28-30.
[25]H.Wang,W.Li,H.He,et al.320-Detector row CT angiography for detection and evaluation of intracranial aneurysms:Comparison with conventional digital subtraction angiography[J].Clinical Radiology,2013,68:e15-e20.
[26]吴永刚,张诚,黄啸元,等.CTA对诊断颅内动脉瘤的临床价值[J].中国CT和MRI杂志,2016,9(5):21-23.
[27]马睿,周存升.CT血管造影对脑动脉瘤的临床应用价值[J].中华放射学杂志,2000,34(7):476-478.
[28]杨显存,刘强,葛彦彦,等.三维重建技术在颅内动脉瘤诊治中的影响因素[J].实用放射学杂志,2013,29(9):1529-1532.
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