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目的分析64排螺旋CT血管成像(CTA)与数字减影血管造影(DSA)对颅内动脉瘤的诊断及临床应用价值,为颅内动脉瘤的早期诊断提供依据。方法回顾分析2006年4月至2011年11月60例就诊时临床表现疑似颅内动脉瘤患者,全部行头颈联合3D-CTA及DSA检测,以DSA为诊断标准,采用双盲法评估3D-CTA对颅内动脉瘤诊断的灵敏度、准确度及与DSA检出动脉瘤数量的一致性;测量动脉瘤瘤颈宽度,并比较两者之间的差异。结果 60例患者中,49例经DSA检查出51个动脉瘤,50例经CTA检出51个动脉瘤,以DSA诊断为金标准,CTA检查的灵敏度为97.8%,准确度为98.0%,2种诊断方法在检出动脉瘤的例数方面差异无统计学意义(P>0.05),CTA检出瘤颈宽度为(3.6±1.9)mm,DSA为(3.3±2.1)mm,两者差异无统计学意义(P>0.05)。结论 CTA对颅内动脉瘤检查的灵敏度高,可作为颅内动脉瘤筛查的首选方法,但仍不能完全替代DSA。
Objective To analyze the diagnostic value and clinical value of 64-slice spiral CT angiography (CTA) and digital subtraction angiography (DSA) for intracranial aneurysms and provide the basis for the early diagnosis of intracranial aneurysms. Methods From April 2006 to November 2011, 60 patients with clinical manifestations of intracranial aneurysm who were diagnosed as having clinical manifestations were retrospectively analyzed. All patients underwent head-neck combined 3D-CTA and DSA. DSA was used as a diagnostic criteria to evaluate the efficacy of 3D-CTA The sensitivity and accuracy of the diagnosis of intracranial aneurysms and the consistency with the number of aneurysms detected by DSA were measured. The width of aneurysm neck was measured, and the differences between the two methods were compared. Results Of the 60 patients, 51 of 41 aneurysms were detected by DSA in 49 cases and 51 of them were detected by CTA. The sensitivity of DSA was 97.8% and the accuracy was 98.0% There was no significant difference in the number of cases detected by aneurysm (P> 0.05). The width of tumor neck by CTA was (3.6 ± 1.9) mm and DSA was (3.3 ± 2.1) mm, with no difference Statistical significance (P> 0.05). Conclusion CTA has high sensitivity to intracranial aneurysm examination and can be used as a screening method for intracranial aneurysms. However, CTA still can not completely replace DSA.