摘要
目的探讨4D-CTA在脑动静脉畸形(CAVM)病灶检出及内部血管结构显示方面的价值。方法选取40例经DSA证实的CAVM患者的4D-CTA资料,由两位医师采用双盲法回顾性分析4D-CTA和DSA检查结果,用统一的数据表记录每个诊断项目,以DSA作为诊断金标准进行对照分析。采用SPSS 17.0统计软件进行数据处理,对4D-CTA和DSA结果进行Kappa一致性检验,评价4D-CTA检查在检测瘤巢大小、引流静脉及供血动脉方面的能力。Kappa系数<0.40表示一致性差,0.41～0.60表示一致性中等,0.61～0.80表示一致性好,>0.80表示一致性极好,P<0.05为差异有统计学意义。结果在判断CAVM病灶位置、大小及引流静脉方面,4D-CTA与DSA的符合率为100%,两种检查一致性极好(K=1,P<0.05)。在显示主要供血动脉方面,4D-CTA与DSA的符合率为95%,两种检查一致性极好(K=0.85,P<0.05)。在确定较小的动脉分支或分支细节时,4D-CTA的清晰度低于DSA。结论在检出CAVM病变,判断瘤巢位置、大小、主要供血动脉和引流静脉等方面,4D-CTA具有独特优势,在CAVM诊断中具有较高的应用价值。
Objective To evaluate the value of four-dimensional CT angiography （4D-CTA） in diagnosis of cerebral arteriovenous malformation （CAVM）. Methods Forty patients with CAVM diagnosed by DSA were included in this research. The patients perform 4D-CTA using 320-detector row CT scanner. All results of 4D-CTA were documented in a standardized scoring sheet, and blind to the results of DSA examinations. SPSS 17.0 statistical software was used for data processing. 4D-CTA and DSA results were assessed using Kappa consistency test to evaluate the ability to detect the size of the nidus, draining veins and feeding arteries. Kappa coefficient 〈 0.40 indicated poor consistency ,0.41 -0.60 the consistency medium ,0.61 -0.80 indicated consistency, 〉 0.80 indicated excellent consisterey ,P 〈 0.05 was considered statistically significant. Results The results of 4D-CTA in all 40 cases were fully consistent with DSA in displaying locations, size and draining veins of CAVM. There is excellent consistency beterrn 4D-CTA and DSA. but was difference in identifying smaller and specific arterial branches. Conclusion 4D-CTA could detect all the lesions of CAVM, including size, locations, feeding arteries and drainage veins, and has higher potential diagnostic value in evaluating CAVM, which provides a basis for clinical treatment strategies.
出处
《临床放射学杂志》
CSCD
北大核心
2013年第4期460-463,共4页
Journal of Clinical Radiology
