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目的:研究探讨二维数字减影血管造影(2D-DSA)、双能量CT血管造影(DE-CTA)及三维动态增强磁共振血管造影(3D DCE-MRA)三种方式诊断脑动脉瘤的临床应用价值。方法:选取2012年01月至2016年05月于医院住院诊治的60例疑诊为脑动脉瘤的蛛网膜下腔出血(SAH)患者,对所有患者行DE-CTA、3D DCE-MRA、2D-DSA检查,行三维数字减影血管造影(3DDSA)检查进行确诊,观察对比分析三种不同的检查方式诊断脑动脉瘤的差异。结果:在脑动脉瘤瘤体的短径及长径的测量方面,三种检查方式的诊断之间无显著性的差异(P>0.05);在脑动脉瘤瘤颈的横径的测量方面,DE-CTA与3D DCE-MRA两种检查方式之间无明显的差异(P>0.05),而两者与2D-DSA之间表现出显著的差异性(P<0.05);在动脉瘤的瘤颈与邻近载瘤动脉间的空间结构显示方面,三种检查方式之间相比较差异较大,具有统计学意义(P<0.05)。结论:DE-CTA及3D DCE-MRA作为一种无创性的筛查手段,有漏诊可能,应考虑进一步行3D-DSA检查明确。同时,2D-DSA作为3D-DSA及后期介入治疗的基础,能提供更详细的脑血管血流动力学方面的信息,具有不可替代的作用。
Objective: To study the clinical value of 2D-DSA, DE-CTA and 3D DCE-MRA in the diagnosis of cerebral aneurysms Value. Methods: From January 2012 to May 2016, 60 patients with subarachnoid hemorrhage (SAH) who were diagnosed as cerebral aneurysm in hospital were enrolled in this study. All patients underwent DE-CTA, 3D DCE-MRA, 2D -DSA examination, three-dimensional digital subtraction angiography (3DDSA) examination was confirmed, the comparative analysis of three different examination methods to diagnose differences in cerebral aneurysms. Results: There was no significant difference in the measurement of short axis and long axis of aneurysm tumor (P> 0.05) between the three examinations. In the measurement of transverse diameter of cerebral aneurysm neck, The difference between DE-CTA and 3D-DCE-MRA was not significant (P> 0.05), but significant difference was found between 2D-DSA and DE-CTA (P <0.05) There was a significant difference between the three examinations in the spatial structure of the neck and the adjacent parent artery, with statistical significance (P <0.05). Conclusion: DE-CTA and 3D DCE-MRA as a non-invasive screening methods, missed diagnosis, should be considered further 3D-DSA examination clear. At the same time, 2D-DSA, as the basis of 3D-DSA and post-interventional therapy, can provide more detailed information on hemodynamics of cerebrovascular and has an irreplaceable role.