4D-CTA对颅内动脉瘤诊断的应用价值

发布时间：2018-11-19 16:56

【摘要】：目的与常规三维血管造影(3D-CTA)对比,探讨四维血管造影(4D-CTA)对颅内动脉瘤诊断的价值。方法将80例怀疑颅内动脉瘤或因眩晕入院患者随机分为2组(每组40例),A组采用4D-CTA扫描模式检查,对比剂30 ml;B组采用常规3D-CTA扫描模式检查,对比剂60 ml。测量颈内动脉及大脑中动脉CT值、噪声、信噪比(SNR)、对比噪声比(CNR)进行客观图像质量评价。使用5分法进行主观图像质量评价。对比A组与B组间辐射剂量。对进行DSA检查的患者,以DSA为金标准计算4D-CTA对颅内动脉瘤诊断的准确性。结果 A组颈内动脉及大脑中动脉的CT值高于B组(P0.01)。A组与B组的颈内动脉及大脑中动脉SNR无显著差异(分别为P=0.68、P=0.25)。A组与B组的颈内动脉及大脑中动脉CNR无显著差异(分别为P=0.89、P=0.59)。A组与B组间主观图像质量评价无显著差异(P0.05)。A组辐射剂量较B组降低30%。4D-CTA对颅内动脉瘤诊断的特异性、敏感性、阳性预测值、阴性预测值及准确率分别为94.12%、90.00%、94.12%、90.00%、92.59%。结论 4DCTA由低辐射剂量、低对比剂浓度扫描实现的动态脑血管成像图像质量不低于常规3D-CTA。4D-CTA对颅内动脉瘤的诊断有较高的准确性。
[Abstract]:Objective to evaluate the value of four dimensional angiography (4D-CTA) in the diagnosis of intracranial aneurysms compared with conventional three-dimensional angiography (3D-CTA). Methods 80 patients with suspected intracranial aneurysms or patients with vertigo were randomly divided into two groups (40 patients in each), A group were examined by 4D-CTA scan mode, 30 ml;B group by conventional 3D-CTA scan mode and 60 ml. by contrast agent). The internal carotid artery (ICA) and middle cerebral artery (MCA) were measured by CT, noise and SNR were compared with (CNR) to evaluate the image quality. The 5-score method was used to evaluate the subjective image quality. The radiation doses between group A and group B were compared. The accuracy of 4D-CTA in the diagnosis of intracranial aneurysms was calculated with DSA as gold standard in patients with DSA. Results the CT values of the internal carotid artery and the middle cerebral artery in group A were higher than those in group B (P0.01). A and group B, respectively). There was no significant difference in SNR between the internal carotid artery and the middle cerebral artery in group B (P0. 68, respectively. There was no significant difference in CNR of internal carotid artery and middle cerebral artery between P0. 25). A group and B group (P < 0. 89, P < 0. 89). There was no significant difference in subjective image quality evaluation between). A group and group B (P0.05) radiation dose in). A group decreased the specificity, sensitivity and positive predictive value of 30%.4D-CTA in the diagnosis of intracranial aneurysm. The negative predictive value and the accuracy rate were 94.12 and 94.12, respectively. Conclusion the imaging quality of 4DCTA by low radiation dose and low contrast medium concentration scanning is not lower than that of conventional 3D-CTA.4D-CTA in the diagnosis of intracranial aneurysms.
【作者单位】：南京大学附属金陵医院医学影像科;
【分类号】：R743;R816.1

【参考文献】