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目的:以三维数字减影血管造影(three-dimensional rotational digital subtraction angiography,3D-DSA)和(或)手术结果为金标准,评价数字减影CT血管造影(computed tomographic angiography,CTA)对自发性蛛网膜下腔出血(subarachnoid hemorrhage,SAH)中动脉瘤的诊断价值。方法:回顾性分析56例因自发性SAH而行数字减影CTA检查的影像资料,评估图像质量,确定并记录动脉瘤的有无、数量、位置、大小等,以3D-DSA和(或)手术结果为参考标准,计算数字减影CTA对颅内动脉瘤诊断的敏感性与特异性,对比数字减影CTA与常规CTA对动脉瘤的显示效果。结果:11例患者没有检出动脉瘤,另外45例患者共发现57个动脉瘤。以患者例数为单位,数字减影CTA对SAH中动脉瘤诊断的敏感性与特异性均为100%;以动脉瘤个数为单位,诊断的敏感性与特异性分别为96.49%、100%,漏诊的动脉瘤均为隐匿性、非破裂的微小动脉瘤。数字减影CTA对SAH中动脉瘤的显示效果优于常规CTA(P均<0.05)。结论:数字减影CTA对自发性SAH中动脉瘤具有较高的检出率,可作为首选的影像检查方法。
OBJECTIVE: To evaluate the effect of computed tomographic angiography (CTA) on spontaneous spider webs by using three-dimensional rotational digital subtraction angiography (3D-DSA) and / or surgical findings as the gold standard. Diagnostic value of aneurysm in subarachnoid hemorrhage (SAH). Methods: A retrospective analysis of 56 cases of digital subtraction CTA due to spontaneous SAH image data to assess the image quality, to determine and record the aneurysm presence, quantity, location, size, 3D-DSA and / The surgical results were taken as the reference standard to calculate the sensitivity and specificity of digital subtraction CTA for the diagnosis of intracranial aneurysms. The contrast between digital subtraction CTA and conventional CTA was analyzed. Results: No aneurysm was detected in 11 patients and 57 aneurysms were found in 45 patients. According to the number of patients, the sensitivity and specificity of digital subtraction CTA in diagnosis of aneurysm in SAH were 100%. The sensitivity and specificity of digital subtraction CTA in diagnosis of aneurysms were 96.49%, 100% , Missed aneurysms were occult, non-ruptured aneurysm. Digital subtraction CTA showed better aneurysm in SAH than conventional CTA (all P <0.05). Conclusion: Digital subtraction CTA has high detection rate of aneurysm in spontaneous SAH, which can be used as the first choice of imaging method.