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目的:通过与数字减影血管造影(DSA)和外科手术结果对比,评价16层螺旋CT血管造影(CTA)对颅内动脉瘤诊断的准确性。方法:对356例临床怀疑颅内动脉瘤患者的16层螺旋CTA图像与DSA和外科手术结果进行回顾性对比研究。结果:结合CTA、DSA和术中所见,在356例患者中的195例患者颅内发现215个动脉瘤。5个动脉瘤CTA漏诊,9个动脉瘤在DSA检查中未能清楚显示,但被CTA发现,其中5个得到手术证实,另外4个未行手术治疗。16层螺旋CTA对于动脉瘤检出的敏感性与DSA的结果差别没有统计学意义。结论:16层螺旋CTA对于颅内动脉瘤检出具有很高的敏感性、特异性和准确性,在颅内动脉瘤的筛选、诊断和治疗方案的制定方面可以替代常规DSA检查。
OBJECTIVE: To evaluate the diagnostic accuracy of 16-slice spiral CT angiography (CTA) for intracranial aneurysms compared with digital subtraction angiography (DSA) and surgical results. Methods: A retrospective comparison of 16-slice spiral CTA images with DSA and surgical findings in 356 patients with clinically suspected intracranial aneurysms was performed. Results: In combination with CTA, DSA and intraoperative findings, 215 aneurysms were found intracranially in 195 of the 356 patients. Five aneurysms were missed by CTA and nine aneurysms were not clearly demonstrated by DSA, but were found by CTA, of which five were confirmed by surgery and the other four were not surgically treated. The sensitivity of 16-slice CTA for detecting aneurysms was not statistically different from that of DSA. Conclusion: The 16-slice CTA has high sensitivity, specificity and accuracy in the detection of intracranial aneurysms. It can replace conventional DSA in the screening, diagnosis and treatment of intracranial aneurysms.