容积CT数字减影血管造影诊断颅内动脉瘤的价值及影响因素

发布时间：2018-01-06 21:32

本文关键词：容积CT数字减影血管造影诊断颅内动脉瘤的价值及影响因素　出处：《中国医学影像技术》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨容积CT数字减影血管造影(VCTDSA)检出颅内动脉瘤的影响因素。方法回顾性分析204例自发性蛛网膜下腔出血(SAH)患者的临床、VCTDSA及3D-DSA资料,观测颅内动脉瘤的数量、位置、大小、颅内血管情况及减影后颅底骨质去除效果,计算VCTDSA诊断颅内动脉瘤的敏感度、特异度、阴性及阳性预测值,分析影响VCTDSA颅内动脉瘤诊断的相关因素。结果 204例SAH患者中3D-DSA共检出178例246个颅内动脉瘤,VCTDSA共检出180例248个颅内动脉瘤,其中多发动脉瘤51例119个。以3D-DSA为金标准,VCTDSA因血管痉挛及载瘤动脉解剖变异漏诊2个动脉瘤,因头部运动、血管痉挛及部分容积效应误诊4个动脉瘤。VCTDSA诊断颅内动脉瘤的敏感度、特异度、阳性预测值、阴性预测值分别为99.17%(244/246)、84.62%(22/26)、98.39%(244/248)、91.67%(22/24)。VCTDSA对最大径≤3mm的颅内动脉瘤的敏感度为96.72%(59/61);对3 mm的颅内动脉瘤敏感度为100%(187/187)。结论VCTDSA对颅内动脉瘤的诊断效能与3D-DSA相似;动脉瘤的大小、血管痉挛、载瘤动脉解剖变异及检查时的头部运动是影响VCTDSA诊断颅内动脉效能的主要因素。
[Abstract]:Objective to investigate the volume CT digital subtraction angiography (VCTDSA) and influencing factors for detection of intracranial aneurysms. Methods a retrospective analysis of 204 cases of spontaneous subarachnoid hemorrhage (SAH) patients, VCTDSA and 3D-DSA data, the number of observations, intracranial aneurysm location, size, and reduction of intracranial vascular removal after skull base the calculation and diagnosis of intracranial aneurysms with VCTDSA sensitivity, specificity, negative and positive predictive value, analysis of factors affecting VCTDSA diagnosis of intracranial aneurysms. Results 204 cases of SAH patients in 3D-DSA were detected in 178 cases with 246 intracranial aneurysms, VCTDSA were detected in 180 patients with 248 intracranial aneurysms, including multiple aneurysms 119. 51 cases with 3D-DSA as the gold standard, VCTDSA because of vasospasm and parent artery anatomy variation missed 2 aneurysms, because of head movement, vasospasm and partial volume effects of misdiagnosis of 4 aneurysms.VCTDSA diagnosis of intracranial Aneurysm sensitivity, specificity, positive predictive value, negative predictive value were 99.17% (244/246), 84.62% (22/26), 98.39% (244/248), 91.67% (22/24) of intracranial aneurysms on the maximum diameter less than or equal to 3mm the sensitivity of.VCTDSA was 96.72% (59/61); intracranial aneurysm of 3 mm the sensitivity was 100% (187/187). Conclusion 3D-DSA and VCTDSA diagnosis of intracranial aneurysm; aneurysm size, vascular spasm, aneurysms and anatomical variation examination of the head movement is the main factor affecting the effectiveness of VCTDSA in diagnosis of intracranial artery.

【作者单位】：重庆医科大学附属第一医院放射科;
【基金】：重庆市卫计委医学科研项目(2013-2-017) 国家临床重点专科建设项目(国卫办医函[2013]544号)
【分类号】：R743;R816.1
【正文快照】： 例248个颅内动脉瘤,其中多发动脉瘤51例119个。以3D-DSA为金标准,VCTDSA因血管痉挛及载瘤动脉解剖变异漏诊2个动脉瘤,因头部运动、血管痉挛及部分容积效应误诊4个动脉瘤。VCTDSA诊断颅内动脉瘤的敏感度、特异度、阳性预测值、阴性预测值分别为99.17%(244/246)、84.62%(22/26)

【相似文献】