中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2010年
3期
229-233
,共5页
付凤丽%陈伟建%杨运俊%王宏清%段玉霞%杨博洋%林元为%谭显西%钟鸣%诸葛启钏
付鳳麗%陳偉建%楊運俊%王宏清%段玉霞%楊博洋%林元為%譚顯西%鐘鳴%諸葛啟釧
부봉려%진위건%양운준%왕굉청%단옥하%양박양%림원위%담현서%종명%제갈계천
颅内动脉瘤%体层摄影术,X线计算机%蛛网膜下腔出血
顱內動脈瘤%體層攝影術,X線計算機%蛛網膜下腔齣血
로내동맥류%체층섭영술,X선계산궤%주망막하강출혈
Intracranial aneurysm%Tomography,X-ray computed%Subarachnoid hemorrhage
目的 探讨MSCTA对最大径≤3 mm颅内微小动脉瘤(IMA)的诊断价值.方法 回顾性分析连续826例可疑颅内动脉瘤患者的临床和影像资料.全部患者住院前(发病后2 h～4 d)均采用16层螺旋CT行MSCTA,全部颅内动脉瘤均经DSA、三维旋转数字减影血管造影(3DRA)或手术证实.MSCTA、DSA及3DRA等影像资料由2名放射科医师独立进行分析.以DSA或3DRA为标准,计算MSCTA诊断IMA的敏感性、特异性及准确度,采用Kappa分析,评价DSA或3DRA与MSCTA两种检查方法诊断颅内IMA的一致性.采用X~2检验分析IMA与非IMA患者多发动脉瘤的患病率.结果 826例可疑颅内动脉瘤患者中,788例为颅内动脉瘤患者,单发706例,多发82例,共发现889个动脉瘤,38例MSCTA、DSA或3DRA检查结果均为阴性.经DSA或3DRA检查证实,212例患者(271个动脉瘤)共有232个IMA.MSCTA检出229个IMA,假阳性1例,漏诊4个.以DSA或3DRA为标准,MSCTA诊断IMA的敏感性、特异性、准确度分别为98.3%(228/232)、97.4%(38/39)、98.2%(266/271).两种检查方法有较强的一致性(Kappa值为0.927,P<0.05).IMA与非IMA患者多发动脉瘤患病率分别为21.2%(45/212)、6.4%(37/576),差异有统计学意义(X~2=36.421,P<0.01).结论 MSCTA诊断IMA具有较高价值,鉴于MSCTA对IMA的检出达到≤3 mm水准,提出将颅内IMA影像大小界定从4～5 mm调整为≤3 mm.
目的 探討MSCTA對最大徑≤3 mm顱內微小動脈瘤(IMA)的診斷價值.方法 迴顧性分析連續826例可疑顱內動脈瘤患者的臨床和影像資料.全部患者住院前(髮病後2 h～4 d)均採用16層螺鏇CT行MSCTA,全部顱內動脈瘤均經DSA、三維鏇轉數字減影血管造影(3DRA)或手術證實.MSCTA、DSA及3DRA等影像資料由2名放射科醫師獨立進行分析.以DSA或3DRA為標準,計算MSCTA診斷IMA的敏感性、特異性及準確度,採用Kappa分析,評價DSA或3DRA與MSCTA兩種檢查方法診斷顱內IMA的一緻性.採用X~2檢驗分析IMA與非IMA患者多髮動脈瘤的患病率.結果 826例可疑顱內動脈瘤患者中,788例為顱內動脈瘤患者,單髮706例,多髮82例,共髮現889箇動脈瘤,38例MSCTA、DSA或3DRA檢查結果均為陰性.經DSA或3DRA檢查證實,212例患者(271箇動脈瘤)共有232箇IMA.MSCTA檢齣229箇IMA,假暘性1例,漏診4箇.以DSA或3DRA為標準,MSCTA診斷IMA的敏感性、特異性、準確度分彆為98.3%(228/232)、97.4%(38/39)、98.2%(266/271).兩種檢查方法有較彊的一緻性(Kappa值為0.927,P<0.05).IMA與非IMA患者多髮動脈瘤患病率分彆為21.2%(45/212)、6.4%(37/576),差異有統計學意義(X~2=36.421,P<0.01).結論 MSCTA診斷IMA具有較高價值,鑒于MSCTA對IMA的檢齣達到≤3 mm水準,提齣將顱內IMA影像大小界定從4～5 mm調整為≤3 mm.
목적 탐토MSCTA대최대경≤3 mm로내미소동맥류(IMA)적진단개치.방법 회고성분석련속826례가의로내동맥류환자적림상화영상자료.전부환자주원전(발병후2 h～4 d)균채용16층라선CT행MSCTA,전부로내동맥류균경DSA、삼유선전수자감영혈관조영(3DRA)혹수술증실.MSCTA、DSA급3DRA등영상자료유2명방사과의사독립진행분석.이DSA혹3DRA위표준,계산MSCTA진단IMA적민감성、특이성급준학도,채용Kappa분석,평개DSA혹3DRA여MSCTA량충검사방법진단로내IMA적일치성.채용X~2검험분석IMA여비IMA환자다발동맥류적환병솔.결과 826례가의로내동맥류환자중,788례위로내동맥류환자,단발706례,다발82례,공발현889개동맥류,38례MSCTA、DSA혹3DRA검사결과균위음성.경DSA혹3DRA검사증실,212례환자(271개동맥류)공유232개IMA.MSCTA검출229개IMA,가양성1례,루진4개.이DSA혹3DRA위표준,MSCTA진단IMA적민감성、특이성、준학도분별위98.3%(228/232)、97.4%(38/39)、98.2%(266/271).량충검사방법유교강적일치성(Kappa치위0.927,P<0.05).IMA여비IMA환자다발동맥류환병솔분별위21.2%(45/212)、6.4%(37/576),차이유통계학의의(X~2=36.421,P<0.01).결론 MSCTA진단IMA구유교고개치,감우MSCTA대IMA적검출체도≤3 mm수준,제출장로내IMA영상대소계정종4～5 mm조정위≤3 mm.
Objective To investigate the value of multi-slice computed tomography angiography (MSCTA)in the detection of intracranial micro-aneurysms(aneurysm≤3 mm in maximal diameter, IMA).Methods The clinical history and images of 826 patients with suspected intracranial aneurysms were retrospectively analyzed.All patients underwent MSCTA on 16-slice row CT before hospitalization(from 2 h to 4 d after symtom onset).All intracranial aneurysms were confirmed by digital subtraction angiography (DSA), three-dimensional rotational angiography (3DRA) or surgery.Two independent radiologists assessed all the images.The MSCTA findings were compared with the DSA/3DRA results.The sensitivity, specificity, and accuracy of MSCTA for diagnosis of IMA was calculated.The diagnostic consistency between DSA/3 DRA and MSCTA was determined by Kappa statistics.The prevalence of multiple aneurysms between the group of patients with IMA and the group of patients without IMA was evaluated by Chi-square test Results A total of 889 aneurysms in 788 of the 826 patients were detected.Among them, 706 patients had single aneurysm and 82 patients had multiple aneurysms.No aneurysms were detected in 38 patients.Among the 212 patients who underwent DSA/3 DRA, 271 aneurysms were found and 232 were IMA.MSCTAdetected 229 IMA.There was 1 false-positive finding and 4 false-negative findings by MSCTA.The sensitivity, specificity and accuracy of MSCTA for IMA was 98.3% (228/232), 97.4% (38/39), 98.2% (266/271).There was excellent agreement between two techniques (Kappa=0.927, P<0.05).The prevalence of multiple aneurysms was 21.2% (45/212) in the patient group with IMA and 6.4% (37/576) in the group without IMA.There was statistically significant difference between the two groups (X~2=36.421, P<0.01).Conclusions The detection value of IMA by MSCTA was high.The cutoff level of diameter of intracranial IMA should be adjusted from 4-5 mm to ≤3 mm.
