摘要
目的将去骨剪影CT血管造影(CTA)和核磁共振血管造影(MRA)影像学表现与数字减影血管造影(DSA)对比,探讨两种检查方法对颅内动脉瘤的诊断价值。方法选择2017年10月~2020年9月华北理工大学附属医院收治的临床症状疑为动脉瘤或蛛网膜下腔出血患者90例,回顾性分析其CTA、MRA及DSA影像学检查资料。以DSA为金标准,测量瘤体及瘤颈大小,并计算长径/瘤颈比,对比两种检查方法在不同大小动脉瘤检出数量、瘤体形态及灵敏度、特异度方面的差异。结果DSA检查共有77例发现动脉瘤82个,其中68个动脉瘤体直径>3mm,14个直径≤3mm。CTA发现80个动脉瘤,MRA发现78个动脉瘤。在直径>3mm动脉瘤中,CTA、MRA检出率与DSA差异均无统计学意义(P>0.05),且均与DSA表现出较好的一致性,Kappa值分别为0.956和0.827;在直径≤3mm动脉瘤中,CTA、MRA检出率与DSA差异均无统计学意义(P>0.05),CTA与DSA一致性一般,Kappa值为0.630,MRA与DSA一致性较差,Kappa值为0.262。在对直径>3mm动脉瘤的测量中,CTA和MRA的灵敏度、特异度、阳性预测值、阴性预测值及准确度分别为98.5%、100%、100%、92.9%、98.8%以及95.6%、92.3%、98.5%、80.0%、95.1%;在对直径≤3mm动脉瘤的测量中,CTA、MRA的灵敏度、特异度、阳性预测值、阴性预测值及准确度分别为78.6%、84.6%、84.6%、78.6%、81.5%以及57.1%、69.2%、66.7%、60.0%、63.0%。CTA、MRA灵敏度和特异度差异无统计学意义(P>0.05)。CTA、MRA测量动脉瘤长径、瘤颈及长径/瘤颈比所得数据与DSA比较差异均无统计学意义(P>0.05)。结论CTA和MRA对动脉瘤的诊断效能与DSA相当,可做为临床可靠的影像学检查手段。
Objective To investigate the diagnostic value of CTA and MRA in intracranial aneurysms by comparing the imaging findings of CTA and MRA with DSA.Methods From October 2017 to September 2020,90 patients with suspected clinical symptoms of aneurysm or subarachnoid hemorrhage admitted to the Affiliated Hospital of North China University of Science and Technology were selected to retrospectively analyze their CTA,MRA and DSA imaging examination data.DSA was used as the gold standard to measure the size of aneurysm and its neck,and calculate the ratio of length diameter to tumor neck.The differences in the number of aneurysms detected,tumor shape,sensitivity and specificity between the two methods were compared.Results A total of 82 aneurysms were found in 77 cases by DSA,of which 68 aneurysms were larger than 3mm in diameter and 14 were smaller than 3mm in diameter.CTA found 80 and MRA found 78.There was no significant difference between the two methods and DSA in diameter>3mm aneurysms,and both showed good consistency with DSA,kappa values were 0.956 and 0.827,respectively;in aneurysms with diameter≤3mm,there was no significant difference between the two methods and DSA but CTA and DSA had a general consistency,with kappa value of 0.The kappa value was 0.262.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CTA and MRA were 98.5%,100%,100%,92.9%,98.8% and 95.6%,92.3%,98.5%,80.0% and 95.1%respectively in aneurysms with diameter larger than 3mm;the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CTA and MRA were 78.6%,84.6%,84.6%,78.6%,81.5% and 57.1%,69.2%,66.7%,60.0%,63.0%.There was no significant difference in sensitivity and specificity between the two methods(P>0.05).There was no significant difference between the two methods and DSA in the measurement of aneurysm length diameter,aneurysm neck and length diameter/tumor neck ratio(P>0.05).Conclusion CTA and MRA have the same diagnostic efficiency as DSA in the diagnosis of aneurysms,which can be used as clinical reliable imaging means.
作者
孙凤涛
齐志
张厚宁
禹璐
盛佳曦
SUN Fengtao;QI Zhi;ZHANG Houning(North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China)
出处
《华北理工大学学报（医学版）》
2021年第5期368-373,共6页
Journal of North China University of Science and Technology：Health Sciences Edition
关键词
颅内动脉瘤
CT血管造影成像
核磁共振血管成像
Intracranial aneurysms
Computerized tomography angiography
Magnetic resonance angiography
作者简介
孙凤涛(1982-),男,硕士研究生。研究方向:医学影像诊断与鉴别诊断。
