三维CT血管造影在颅内动脉瘤诊治中的临床价值

目的探讨三维CT血管造影(3D-CTA)在颅内动脉瘤诊治中的临床应用价值。方法回顾性分析自2006年1月至2009年3月以来72例颅内动脉瘤患者的3D-CTA及DSA影像学资料,3D-CTA及DSA图像分别由两位神经外科医师及放射科医师采用双盲法进行对比分析。结果经手术证实72例患者共85个动脉瘤,其中单发动脉瘤61例;多发动脉瘤11例,9例发现2个动脉瘤,2例发现3个动脉瘤。3D-CTA发现67例80个动脉瘤,而DSA发现70例83个动脉瘤。动脉瘤体最大径及瘤颈宽度的测量值在CTA与DSA组间比较无显著性差异(P0.05)。3D-CTA的敏感性及特异性分别为97.65%及94.12%,而DSA的敏感性及特异性则分别为98.82%及97.65%,两组间也无显著差异(P均0.05)。结论 3D-CTA是一种快速、价廉的无创性检查技术,对颅内动脉瘤诊断的敏感性及特异性较高,并可准确显示动脉瘤的位置、形态及大小,较好评估动脉瘤体、载瘤动脉及周围血管之间的关系,从而为选择适当的手术治疗方案提供了可靠的直观依据。

Clinical evaluation of role of 3D-CTA technique in the diagnosis and treatment of intracranial aneurysms

Objective To evaluate the clinical application of three-dimensional computed tomographic angiography（3D-CTA） to patients with intracranial aneurysms.Methods The imaging data of 72 patients with intracranial aneurysms,who underwent surgery in our hospital from January,2006 to March,2009,were analyzed retrospectively.The images of 3D-CTA and DSA were analyzed in double blind way respectively by two radiologists and neurosurgeons.Results Eighty-five intracranial aneurysms were found by surgery in 72 patients,of whom,61 patients suffered from single aneurysms,9 from 2 aneurysms and 2 from 3 aneurysms.Eighty aneurysms were detected by 3D-CTA in 67 patients.Eighty-three aneurysms were detected by DSA in 70 patients.There was no significant difference in tne aneurysmal size and width of the aneurysmal necks（P〉0.05） between 3D-CTA and DSA.For the 3D-CTA,the sensitivity and specificity were 97.65% and 94.12% respectively,and for DSA,they were 98.82% and 97.65% respectively.There was no significant difference in the sensitivity and specificity between 3D-CTA and DSA（P〉0.05）.Conclusions CTA,which is a rapid,cheap and noninvasive method to diagnosis,has a very high sensitivity and specificity for detecting intracranial aneurysms.CTA,which can accurately reveal the location,shape and size of the intracranial aneurysms,and the relationship among the aneurysmal body,parent artery and peripheral vessels,can provide visual and reliable basis for selecting the suitable operating treatment protocols.