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目的探讨三维多层螺旋CT血管成像(3D-MSCTA)对颅内动静脉畸形(AVM)的诊断价值。资料与方法对33例同时行3D-MSCTA和数字减影血管造影(DSA)检查的脑AVM患者的影像资料进行回顾性分析,以DSA为金标准,评价3D-MSCTA诊断准确性,评价指标包括病灶检出率、供血动脉和引流静脉的显示,畸形血管团的部位、形态、大小以及脑内合并病灶。结果 33例患者,3D-MSCTA检出32例35个AVM,1例未检出AVM;DSA检出33例36个AVM,3D-MSCTA检测AVM总的诊断敏感性为96.9%,假阴性率为3.1%。3D-MSCTA在显示AVM血管团、供血动脉及引流静脉方面与DSA没有显著性差异,诊断基本一致;3D-MSCTA同时显示24例DSA无法显示的脑出血。结论 3D-MSCTA是一种基本可以替代DSA作为诊断颅内AVM的无创性的常规筛查方法。
Objective To investigate the diagnostic value of three-dimensional multi-slice spiral CT angiography (3D-MSCTA) for intracranial arteriovenous malformations (AVM). Materials and Methods The imaging data of 33 patients with brain AVM who underwent simultaneous 3D-MSCTA and digital subtraction angiography (DSA) were retrospectively analyzed. DSA was used as the gold standard to evaluate the diagnostic accuracy of 3D-MSCTA. The evaluation criteria included The detection rate of the lesion, the display of the feeding artery and the draining vein, the location of the abnormal blood vessel mass, the shape, the size and the mergence of the brain. RESULTS: Thirty-three AVMs were detected by 3D-MSCTA and one AVM was not detected in one case. Twenty-three AVMs were detected by DSA in 36 patients. The overall diagnostic sensitivity of 3D-MSCTA for detecting AVM was 96.9%. The false-negative rate was 3.1%. 3D-MSCTA showed no significant difference with DSA in displaying AVM vascular groups, feeding arteries and draining veins, and the diagnosis was basically the same. 3D-MSCTA also showed 24 cases of cerebral hemorrhage that DSA could not show. Conclusion 3D-MSCTA is a noninvasive and routine screening method that can substitute DSA for diagnosis of intracranial AVM.