256层3D-CTA与3D-DSA诊断颅内动脉瘤的对比研究

发布时间：2018-05-04 21:32

  本文选题：颅内动脉瘤 + 256层三维CT血管造影　； 参考：《吉林大学》2013年硕士论文

【摘要】：目的： 以三维数字减影血管造影为金标准，探讨256层三维CT血管造影诊断颅内动脉瘤的价值。 方法： 收集我院2010年10月-2012年12月43例蛛网膜下腔出血并同时行3D-CTA与3D-DSA检查的病例。 1、以3D-DSA为金标准，评价3D-CTA的敏感性，特异性，阳性预测值，阴性预测值。并比较3D-CTA与3D-DSA在动脉瘤的检出率上有无统计学差异。 2、以3D-DSA造影测量结果为金标准，比较3D-CTAVR与3D-DSAVR以及二者与3D-DSA造影比较在测量动脉瘤瘤颈及动脉瘤瘤体长径方面的差异。 3、以3D-DSA为金标准，比较3D-CTA与3D-DSA在动脉瘤瘤颈显示的清晰度方面有无差异。 结果： 以动脉瘤数目计算，3D-CTA的敏感性为90.2%，≤3mm的动脉瘤的敏感性85.7%，3mm的动脉瘤敏感性为95.0%。以病例数计算，3D-CTA的敏感性、特异性、阳性预测值、阴性预测值分别为91.6%、85.7%、97.0%、66.7%。3D-CTA与3D-DSA在颅内动脉瘤检出率方面差异无统计学意义。3D-CTA与3D-DSA造影图像在瘤颈与瘤体长径测量方面P0.05，差异无统计学意义。3D-CTA与3D-DSA(VR)在动脉瘤瘤颈及瘤体长径测量方面,P0.05，，差异有统计学意义。3D-DSA(VR)与3D-DSA造影图像在瘤颈与瘤体长径测量方面P0.05，差异有统计学意义。3D-CTAVR与3D-DSAVR在显示动脉瘤瘤颈及载瘤动脉清晰度方面差异有统计学意义。 结论： 1、3D-CTA与3D-DSA在总体动脉瘤的检出率上差异无统计学意义，因此3D-CTA可以替代3D-DSA进行颅内动脉瘤的术前诊断。 2、3D-CTAVR所测的数值可以用于术前动脉瘤瘤颈及瘤体长径的测量，而3D-DSAVR所测数值偏大，因此在使用3D-DSAVR测量动脉瘤瘤颈及瘤体长径时应考虑这方面的因素。 3、对于3D-CTAVR未能清晰显示的动脉瘤瘤颈及载瘤动脉要进一步行3D-DSA检查。
[Abstract]:Objective: Using three dimensional digital subtraction angiography as gold standard, the value of 256 slice CT angiography in the diagnosis of intracranial aneurysms was discussed. Methods: From October 2010 to December 2012, 43 cases of subarachnoid hemorrhage were examined by 3D-CTA and 3D-DSA. 1. Using 3D-DSA as gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of 3D-CTA were evaluated. To compare the difference between 3D-CTA and 3D-DSA in the detection rate of aneurysm. 2. According to the results of 3D-DSA, the difference between 3D-CTAVR and 3D-DSAVR and between 3D-CTAVR and 3D-DSA in measuring the length and diameter of aneurysm neck and aneurysm was compared. 3. Using 3D-DSA as the gold standard, the difference between 3D-CTA and 3D-DSA in the definition of aneurysm neck was compared. Results: According to the number of aneurysms, the sensitivity of 3D-CTA was 90.2, the sensitivity of aneurysms 鈮

本文编号：1844723