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目的探讨CT血管造影(CTA)对颅内动脉瘤破裂的预测价值。方法对38例颅内动脉瘤患者进行CTA扫描诊断,以数字减影血管造影(DSA)、CTA确诊为动脉瘤破裂者设为破裂组,测量动脉瘤的长度、瘤颈宽度,计算动脉瘤体颈比(AR)和入射夹角,并对动脉瘤破裂的CTA相关参数进行回归分析。结果 CTA诊断颅内动脉瘤破裂的灵敏度为86.7%、特异度为93.1%、准确性为90.9%。破裂组和未破裂组患者瘤体长度、瘤颈宽度、AR值、入射夹角比较,差异均有统计学意义(P<0.05)。瘤体长度>3.65mm、瘤颈宽度>3.35mm、AR值>1.14、入射夹角>110.5°为动脉瘤发生破裂的危险因素。结论 CTA能准确诊断颅内动脉瘤破裂,通过瘤体长度、高度、AR值及入射夹角可准确评估动脉瘤破裂风险,早期预测动脉瘤破裂。
Objective To investigate the predictive value of CT angiography (CTA) for ruptured intracranial aneurysms. Methods Thirty-eight patients with intracranial aneurysms were diagnosed by CTA scan. The digital subtraction angiography (DSA) and CTA were used to diagnose aneurysm rupture. The length of the aneurysm and the width of tumor neck were measured to calculate the aneurysm Neck ratio (AR) and incidence angle, and regression analysis of CTA-related parameters of aneurysm rupture. Results The sensitivity, specificity and accuracy of CTA in diagnosing intracranial aneurysm rupture were 86.7%, 93.1% and 90.9% respectively. The tumor length, tumor neck width, AR value and incidence angle in rupture group and rupture group were significantly different (P <0.05). Tumor length> 3.65mm, neck width> 3.35mm, AR value> 1.14, incidence angle> 110.5 ° risk factors for the rupture of aneurysms. Conclusion CTA can accurately diagnose the rupture of intracranial aneurysm. The aneurysm rupture risk can be accurately evaluated by the length of aneurysm, height, AR value and incident angle, and aneurysm rupture can be predicted early.