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目的:探讨三维数字减影血管造影(3DDSA)对脑动脉瘤的诊断价值。方法:对91例确诊或疑诊脑动脉瘤患者的2DDSA和3DDSA检查结果进行回顾性对比分析,以脑动脉瘤手术和血管内治疗为参照。结果:91 例患者3DDSA共检出64例92个动脉瘤,27例阴性,2DDSA共检出61例79个动脉瘤,30例阴性,2DDSA和 3DDSA脑动脉瘤诊断阳性率比较差异无统计学意义(P>0．05)。2DDSA有1例假阳性和4例假阴性,有10例 13个动脉瘤未被2DDSA发现(平均1．98 mm),偶然发现未破裂动脉瘤占84．6％。3DDSA对于动脉瘤瘤颈的显示及瘤颈和周围重要血管毗邻关系的评价优于2DDSA(P<0．01)。结论:3DDSA对于脑动脉瘤的诊断和治疗具有很大的临床应用价值。
Objective: To investigate the value of three-dimensional digital subtraction angiography (3DDSA) in the diagnosis of cerebral aneurysm. Methods: The results of 2DDSA and 3DDSA in 91 patients with diagnosed or suspected cerebral aneurysm were retrospectively analyzed. The cerebral aneurysm surgery and endovascular treatment were taken as reference. Results: A total of 64 aneurysms were detected in 64 patients, of which 27 were negative in 3DDSA. A total of 61 aneurysms in 61 patients were detected by 2D DSA, and 30 were negative. There was no significant difference in the diagnostic rates between 2DDSA and 3DDSA cerebral aneurysms (P> 0.05). 2DDSA had one case of false positives and four cases of false negatives. Ten aneurysms were not found by 2DDSA (mean 1.98 mm). Occasionally, unruptured aneurysms accounted for 84.6%. 3DDSA is superior to 2DDSA in displaying the neck of aneurysm and the adjoining neoplasms of neck and surrounding vessels (P <0.01). Conclusion: 3DDSA has great clinical value for the diagnosis and treatment of cerebral aneurysm.