摘要
目的 探讨CT血管造影(CTA)在颅内动脉瘤(IA)诊断中应用价值分析。方法 选取2017年5月至2021年11月诊治的103例疑似IA患者作为研究对象,以数字减影全脑血管造影术(DSA)为“金标准”,经其确诊为IA共65例,并在确诊前予以CT平扫、CTA检查,对比阳性、阴性检出率、诊断确诊率、敏感度、特异度、漏诊率、误诊率,观察颅内动脉瘤病变部位及大小,且采用ROC曲线模型评估CT平扫、CTA诊断颅内动脉瘤的AUC值。结果 103例疑似IA患者经CT平扫检出阳性41例、阳性预测值69.45%,阴性20例、阴性性预测值45.45%,与金标准相比,一致性较差(Kappa=0.152,P>0.05)。经CTA检出阳性60例、阳性预测值为95.24%,阴性36例、阴性预测值87.80%,与金标准相比,一致性较好(Kappa=0.838,P<0.05)。经CTA检出的60例阳性病例中,ICA占5例、ACA占5例、MCA占4例,PCA占11例、Aco A占13例、Pco A占16例、VA占3例、AICA占1例、PICA占3例。经CTA检出的60例阳性病例中,<2mm的动脉瘤占1例、2~5mm的动脉瘤占26例、6~15mm的动脉瘤占16例,16~25mm的动脉瘤占12例、>25mm的动脉瘤占5例。CTA的诊断确诊率、敏感度、特异度高于CT平扫,而漏诊率、误诊率低于CT平扫(P<0.05)。ROC曲线分析显示,CT平扫、CTA诊断IA的AUC分别为(0.575、0.927,P<0.05)。结论 CTA在颅内动脉瘤诊断中具有较高的应用价值,能清晰显示脑动脉瘤特征,可作为筛查颅内动脉瘤的重要手段。
Objective To explore the application value of CT angiography(CTA)in the diagnosis of intracranial aneurysm(IA).Methods A total of 103 patients with suspected IA diagnosed and treated from May 2017 to November 2021 were selected as the research subjects.Digital subtraction angiography(DSA)was used as the gold standard.A total of 65 patients were diagnosed with IA.CT plain scan and CTA examination were performed to compare the positive and negative detection rate,diagnostic confirmation rate,sensitivity,specificity,missed diagnosis rate,and misdiagnosis rate.The lesion location and size of intracranial aneurysm were observed,and the ROC curve model was used to evaluate the CT level.The AUC value of scan and CTA for the diagnosis of intracranial aneurysm.Results In 103 suspected IA patients,41 cases were positive with a positive predictive value of 69.45%,and 20 cases were negative with a negative predictive value of 45.45%.Compared with the gold standard,the consistency was poor(Kappa=0.152,P>0.05).The positive predictive value of 60 cases detected by CTA was 95.24%,and the negative predictive value of 36 cases was 87.80%.Compared with the gold standard,the consistency was better(Kappa=0.838,P<0.05).Among the 60 positive cases detected by CTA,5 were ICA,5 were ACA,4 were MCA,11 were PCA,13 were AcoA,16 were PcoA,3 were VA,and 1 were AICA.,PICA accounted for 3 cases.Among the 60 positive cases detected by CTA,1 aneurysm was less than 2 mm,26 were 2-5 mm,16 were 6-15 mm,12 were 16-25 mm,and 12 were 16-25 mm.Aneurysms>25mm accounted for 5 cases.The diagnostic confirmation rate,sensitivity and specificity of CTA were higher than those of plain CT scan,while the rate of missed diagnosis and misdiagnosis were lower than those of plain CT scan(P<0.05).ROC curve analysis showed that the AUC of CT plain scan and CTA for diagnosing IA were(0.575,0.927,P<0.05).Conclusion CTA has high application value in the diagnosis of intracranial aneurysms,can clean and display the characteristics of cerebral aneurysms,and can be used as
作者
张倩
姜淼淼
黄艳
刘小兰
王超
ZHANG Qian;JIANG Miao-miao;HUANG Yan;LIU Xiao-lan;WANG Chao(Bozhou People's Hospital,Bozhou 236800,Anhui Province,China)
出处
《中国CT和MRI杂志》
2023年第4期1-3,共3页
Chinese Journal of CT and MRI
基金
中国红十字基金会“医学赋能-领航菁英科研项目”资助说明(XM_HR__YXFN_2021_05_24)。
