摘要
目的:探讨三维CT血管造影(three-dimensionalCTangiography,3D-CTA)在急性破裂颅内动脉瘤诊断和治疗中的应用价值。方法:选择东莞市人民医院收治的100例急性破裂颅内动脉瘤患者(2014年1月至2017年3月),采用256层螺旋CT对患者实施3D-CTA检查,再采用数字减影血管造影系统对患者实施三维数字减影血管造影(three-dimensional digital subtraction angiography,3D-DSA)检查,以3D-DSA诊断结果为金标准,计算3D-CTA对颅内动脉瘤急性破裂的诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值,并分析3D-CTA与3D-DSA诊断结果之间的一致性。再对颅内动脉瘤急性破裂确诊患者的影像图进行观察,测量和比较3D-CTA与3D-DSA图像中颅内动脉瘤的瘤体最大径、瘤颈最大径。结果:以3D-DSA诊断结果为金标准,3D-CTA对颅内动脉瘤急性破裂的诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为97.47%、95.24%、96.00%、98.72%、90.91%,与3D-DSA诊断结果比较,P>0.05,差异均无统计学意义。一致性分析发现,3D-CTA与3D-DSA对颅内动脉瘤急性破裂的诊断结果之间的一致性良好,其Kappa值为0.745。3D-CTA与3D-DSA图像中颅内动脉瘤的瘤体最大径、瘤颈最大径比较,P>0.05,差异均无统计学意义。结论:采用3D-CTA对颅内动脉瘤患者瘤体急性破裂可予以灵敏、准确诊断,其诊断价值良好,可作为颅内动脉瘤患者术前主要诊断方法,为其手术方案的制定提供可靠参考依据。
Objective: To evaluate the value of three-dimensional CT angiography(3D-CTA) in the diagnosis and treatment of acute ruptured intracranial aneurysms. Methods: 100 patients with acute ruptured intracranial aneurysms admitted to our hospital(January 2014 to March 2017) were treated with 256-slice spiral CT. The patients underwent 3D-CTA examination and digital subtraction angiography system was used. The patient underwent three dimensional digital subtraction angiography(3D-CTA) examination. The 3D-CTA diagnosis was used as the gold standard to calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 3D-CTA for acute rupture of intracranial aneurysm, and the results of 3D-CTA and 3D-CTA diagnosis were analyzed consistency. The imaging images of patients with acute rupture of intracranial aneurysms were observed. The maximum diameter of the tumor and the maximum diameter of the neck of the intracranial aneurysms in 3D-CTA and 3D-CTA images were measured and compared. Results: The 3D-CTA diagnosis was the gold standard. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 3D-CTA for acute rupture of intracranial aneurysm were 97.47%, 95.24%, 96.00%, 98.72%, 90.91%, respectively, which compared with the diagnosis of 3D-CTA, the difference was not statistically significant, P>0.05. Consistency analysis found that 3D-CTA and 3D-CTA had good agreement between the diagnosis of acute rupture of intracranial aneurysms, with a Kappa value of 0.745. The maximum diameter of the tumor and the maximum diameter of the neck of the intracranial aneurysm in 3D-CTA and 3D-CTA images were compared, P>0.05, and the difference was not statistically significant. Conclusion: The 3D-CTA could be used for sensitive and accurate diagnosis of acute rupture of intracranial aneurysms. It has good diagnostic value and could be used as the main preoperative diagnosis method for patients with intracranial aneurysms. It provides a reliable r
作者
梁满球
陈妙玲
徐文
钟任佳
施德建
LIANG Man-qiu;CHEN Miao-ling;XU Wen(Dongguan People's Hospital,Dongguan 523059,Guangdong Province,P.R.C.)
出处
《中国数字医学》
2019年第12期76-79,共4页
China Digital Medicine
基金
东莞市医疗卫生科技计划一般项目(编号：20131051010120)~~
关键词
颅内动脉瘤
诊断
三维CT血管造影
数字减影血管造影
intracranial aneurysm
diagnosis
three-dimensional CT angiography
digital subtraction angiography
