摘要
目的探讨64层螺旋CT血管成像(CTA)在急性自发性蛛网膜下腔出血(SAH)病因诊断中的价值。方法搜集2015年1月—2022年3月,48例急性自发性SAH患者的临床资料进行回顾性研究。所有患者均完成DSA及CTA检查,SAH病因诊断以DSA检查结果为参考标准。采用χ2检验分析CTA对SAH病因诊断的敏感度、特异度和准确率;采用t检验比较CTA与DSA两种方法测量动脉瘤瘤体及瘤颈最大径检查结果。结果48例中,DSA诊断动脉瘤38例、烟雾病2例、脑动脉硬化2例、静脉窦血栓形成1例、阴性5例;CTA诊断动脉瘤37例、烟雾病2例、脑动脉硬化2例、阴性7例;CTA对SAH病因诊断的敏感度、特异度和准确率分别为95.3%(41/43)、100.0%(5/5)、95.8%(46/48);CTA对瘤体最大径<3 mm的动脉瘤检出率77.8%(7/9),对瘤体最大径≥3 mm的动脉瘤检出率100.0%(32/32);64层CTA和DSA对动脉瘤瘤体最大径、瘤颈最大径>5 mm或≤5 mm及全部动脉瘤的瘤体最大径、瘤颈最大径诊断结果,差异均无统计学意义(P值均>0.05)。结论64层螺旋CTA对SAH的病因诊断准确率较高,可为临床病因诊断和治疗方法的选择提供依据。
Objective To explore the value of 64 muti-slice CT angiography(CTA)in the etiological diagnosis of acute spontaneous subarachnoid hemorrhage(SAH).Methods From January 2015 to March 2022,48 patients diagnosed with SAH were collected for a retrospective study.All patients were examined by DSA and CTA.Using DSA as the reference standard of the SAH etiological diagnosis.The sensitivity,specificity,and accuracy of CTA in detecting the cause of SAH were analyzed withχ~2test.The paired sample t test was used to compare the measurement results of the maximum diameter of the aneurysm body and neck by CTA and DSA.Results Among 48patients,38 aneurysms,2 moyamoya disease,2 cerebral arteriosclerosis,and 1 venous sinus thrombosis were diagnosed by DSA,and 5 were negative.37 aneurysms,2 moyamoya disease,and 2cerebral arteriosclerosis were diagnosed by CTA,and 7 were negative.The sensitivity,specificity,and accuracy of CTA in diagnosing the cause of SAH were 95.3%(41/43),100.0%(5/5),and 95.8%(46/48).The detection rate of CTA was 77.8%(7/9)for aneurysms<3 mm,and for aneurysms≥3 mm was 100.0%(32/32);there was no significant difference between CTA and DSA in the diagnosis of the maximum diameter of aneurysm body,the maximum diameter of aneurysm neck>5 mm,≤5 mm,and the maximum diameter of the aneurysm body and neck of all aneurysms(all P>0.05).Conclusion 64 muti-slice CTA can accurately evaluate the etiological diagnosis of SAH and provide clinical guidance for etiological diagnosis and treatment.
作者
王英
王品箫
罗震
祁培文
刘晶哲
WANG Ying;WANG Pinxiao;LUO Zhen;QI Peiwen;LIU Jingzhe(Department of Radiology,the First Hospital of Tsinghua University,Beijing 100016,China)
出处
《中国研究型医院》
2022年第6期47-51,共5页
Chinese Research Hospitals
