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目的探讨CT血管成像(CTA)与数字减影血管造影(DSA)对颅内动脉瘤的临床应用价值。方法选取2013年5月至2016年5月间沈阳市第二中医医院收治的118例颅内动脉瘤患者,均先行CTA检查,后行DSA检查。比较CTA和DSA对颅内动脉瘤的检出率、灵敏度、准确度及空间关系显示的差异。结果 CTA检查共发现动脉瘤123个,多发11例,假阳性3例。DSA检查共发现动脉瘤122个,多发10例,假阳性2例,两种方法检出的动脉瘤数目比较,差异无统计学意义(P>0.05)。两者所测瘤体直径及瘤颈宽度比较,差异均无统计学意义(均P>0.05)。两者造影图像比较,CTA可通过最大密度投影和三维技术,显示颅内动脉血管瘤大小及形态,瘤颈与载瘤动脉的关系较DSA更清晰,DSA显示细小动静脉及血流方向优于CTA。结论 CTA与DSA诊断颅内动脉瘤,效果相近,CTA易操作且无创,可成为原发性蛛网膜下腔出血的首要诊断根据。
Objective To investigate the clinical value of CT angiography (CTA) and digital subtraction angiography (DSA) for intracranial aneurysms. Methods A total of 118 patients with intracranial aneurysms admitted to Shenyang Second TCM Hospital from May 2013 to May 2016 were examined by CTA before DSA. To compare the detection rate, sensitivity, accuracy and spatial relationship between CTA and DSA for intracranial aneurysms. Results CTA examination found a total of 123 aneurysms, 11 cases were multiple, false positive in 3 cases. A total of 122 aneurysms were found in DSA, 10 were multiple, and 2 were false positive. There was no significant difference in the number of aneurysms detected by DSA and DSA (P> 0.05). There was no significant difference between the measured tumor diameter and tumor neck width (P> 0.05). Compared with DSA, CTA showed the size and morphology of intracranial arterioles by means of maximum density projection and three-dimensional technique. The relationship between tumor neck and its parent artery was clearer than that of DSA. DSA showed that arteriovenous and blood flow directions were better than DSA CTA. Conclusion The diagnosis of intracranial aneurysms by CTA and DSA is similar to that of CTA. CTA is easy to operate and noninvasive and can be the primary diagnostic basis of primary subarachnoid hemorrhage.