摘要
目的探讨多层螺旋CT(MSCT)与三维数字减影血管造影(3D-DSA)重建成像诊断颈内动脉瘤构型中的应用价值。方法回顾性分析71例DSA或手术确诊的颈内动脉瘤患者临床与影像资料,均进行MSCT与三维DSA检查,显示颈内动脉瘤三维空间构型,观察动脉瘤大小、部位、瘤颈等特征及其与周围结构关系,以3D-DSA重建成像结果为标准评估MSCT诊断价值。结果71例疑诊患者中经3D-DSA及MSCT重建成像均确诊颈内动脉瘤64例,经3D-DSA重建成像诊断单发型颈内动脉瘤57例(57枚),多发型颈内动脉瘤7例(16枚),共73枚,其中单泡型51枚,双泡及多泡型22枚,双泡及多泡型阳性率为34.14%。MSCT重建成像诊断单发型颈内动脉瘤58例(58枚),多发型颈内动脉瘤6例(13枚),共71枚,其中单泡型57枚,双泡及多泡型14枚,双泡及多泡型阳性率为19.72%,双泡及多泡型阳性率与3D-DAS重建成像的比较差异无统计学意义(P>0.05);以3D-DSA重建成像诊断结果为金标准,MSCT重建成像的诊断效能为:灵敏度98.43%、特异度85.71%,准确率97.18%,阳性预测值98.43%,阴性预测值85.71%,Kappa值为0.857,具有较强一致性(P<0.05)。结论MSCT重建成像可较为准确地对颈内动脉瘤进行诊断及分型,患者术前采用MSCT重建成像进行评估能够为其手术治疗提供全面、直观、准确的影像学信息。
Objective To explore the application value of multi-slice spiral CT(MSCT)and three-dimensional digital subtraction angiography(3D-DSA)reconstruction imaging in the diagnosis of internal carotid artery aneurysm configuration.Methods The clinical and imaging data of 71 patients with internal carotid artery aneurysms diagnosed by DSA or surgery were analyzed retrospectively.MSCT and 3D-DSA were performed.Reconstruction imaging showed the three-dimensional configuration of internal carotid artery aneurysm.The features of size,location and aneurysm neck and their relationship with the surrounding structure were observed.The 3D-DSA reconstruction imaging results were taken as standards to evaluate the diagnostic value of MSCT.Results Among the 71 suspected patients,64 cases of internal carotid artery aneurysms were diagnosed by 3D-DSA and MSCT reconstruction imaging.There were 57 cases(57 aneurysms)of single-type internal carotid artery aneurysms and 7 cases(16 aneurysms)of multiple-type internal carotid artery aneurysms were diagnosed by 3D-DSA reconstruction imaging,thus there were a total of 73 aneurysms(including 51 single-vesicular aneurysms,22 double-vesicular and multi-vesicular aneurysms),and the positive rate of double-vesicular and multi-vesicular types was 34.14%.There were 58 cases(58 aneurysms)of single-type internal carotid artery aneurysms and 6 cases(13 aneurysms)of multiple-type internal carotid artery aneurysms were diagnosed by MSCT reconstruction imaging,thus there were a total of 71 aneurysms(including 57 single-vesicular type,14 double-vesicular and multi-vesicular type),and the positive rate of double-vesicular and multi-vesicular types was 19.72%,and there was no significant difference in the positive rate of double-vesicular and multi-vesicular types compared with that by 3D-DAS reconstruction imaging(P>0.05).Taking diagnostic result of 3D-DSA reconstruction imaging as gold standards,the diagnostic efficacy of MSCT reconstruction imaging showed that the sensitivity,specificity,accuracy rate,positive predictive value,negative predictive value and Kappa value were 98.43%,85.71%,97.18%,98.43%,85.71%and 0.857,and it had strong consistency(P<0.05).Conclusion MSCT reconstruction imaging can accurately diagnose and classify internal carotid artery aneurysms.The preoperative evaluation of MSCT reconstruction imaging can provide comprehensive,intuitive and accurate imaging information for surgical treatment.
作者
彭东
唐兴
何承勇
蒋世杰
PENG Dong;TANG Xing;HE Cheng-yong(Department of Radiology,The Fourth Hospital of Xi'an,Xi'an 710004,Shaanxi Province,China)
出处
《中国CT和MRI杂志》
2020年第1期38-40,43,2,共5页
Chinese Journal of CT and MRI
基金
陕西省自然科学基金(编号:2017SF-245).
关键词
MSCT
三维DSA重建成像
颈内动脉瘤
构型
MSCT
Three-dimensional DSA Reconstruction Imaging
Internal Carotid Artery Aneurysms
Configuration
作者简介
通讯作者:彭东
