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目的利用三维旋转数字减影血管造影(3D-DSA)为对照,评价双能量CT血管成像(DE-CTA)诊断颅内动脉瘤的价值。资料与方法46例临床怀疑颅内动脉瘤的患者同时行3D-DSA。以3D-DSA为对照,以患者和以部位为分析单位计算DE-CTA的诊断准确性。以相似的方法在3D-DSA和DE-CTA上测量动脉瘤长轴、短轴及瘤颈大小。结果3D-DSA证实11例无动脉瘤,35例有40个动脉瘤,动脉瘤平均长轴、短轴及瘤颈大小分别为(5.76±3.39)mm、(4.79±3.27)mm和(3.37±1.72)mm。DE-CTA正确检测了34例患者38个动脉瘤,漏诊2个动脉瘤。以3D-DSA为诊断标准,以患者和动脉瘤部位为分析单位,DE-CTA诊断动脉瘤的敏感性和特异性分别为97.1%、100%和95.0%、100%;诊断≤3 mm动脉瘤的敏感性和特异性分别为80%和100%。DE-CTA检测动脉瘤平均长轴、短轴及瘤颈大小分别为(5.54±3.48)mm、(4.50±3.31)mm和(3.11±1.67)mm;两种技术之间有很好的相关性(r=0.969、0.957、0.870;P=0.000)。结论与3D-DSA相比,单次对比增强DE-CTA在诊断颅内动脉瘤方面有很高的敏感性和特异性,是诊断颅内动脉瘤的有效方法。
Objective To evaluate the value of dual-energy CT angiography (DE-CTA) in the diagnosis of intracranial aneurysms using 3D-DSA as a control. Materials and Methods 46 cases of clinical suspected intracranial aneurysm patients with simultaneous 3D-DSA. Using 3D-DSA as a control, the diagnostic accuracy of DE-CTA was calculated on a patient-by-patient basis. Aortic aneurysms were measured in 3D-DSA and DE-CTA in a similar manner for major axis, minor axis, and neck size. Results There were 11 aneurysms without aneurysms and 40 aneurysms with 35 aneurysms in 3D-DSA. The mean axial length, short axis and neck size of the aneurysms were (5.76 ± 3.39) mm, (4.79 ± 3.27) mm and (3.37 ± 1.72) mm. DE-CTA correctly detected 38 aneurysms in 34 patients and missed 2 aneurysms. The sensitivity and specificity of DE-CTA for the diagnosis of aneurysms were 97.1%, 100% and 95.0%, 100%, respectively, using 3D-DSA as the diagnostic criteria and the location of the patient and aneurysm. The sensitivity and specificity were 80% and 100% respectively. The average long axis, short axis and tumor neck size of the aneurysms detected by DE-CTA were (5.54 ± 3.48) mm, (4.50 ± 3.31) mm and (3.11 ± 1.67) mm, respectively. There was a good correlation between the two techniques (r = 0.969, 0.957, 0.870; P = 0.000). Conclusion Compared with 3D-DSA, single-contrast enhanced DE-CTA in the diagnosis of intracranial aneurysms has a high sensitivity and specificity, is an effective method of diagnosis of intracranial aneurysms.