CAJ | 학술논문

目的：评价常规CTA与减影CTA在脑动脉瘤诊断中的优缺点。方法126例蛛网膜下腔出血患者行CTA检查后，分别进行常规CTA重建及减影CTA重建。由影像科头颈组2名副主任医师采用盲法对两组图像质量分析并进行诊断。126例患者于3-72小时内行金标准DSA检查或开颅动脉瘤夹闭治疗。结果常规法完成MPR、MIP及全脑动脉VR所需要平均的时间为27.17±5.89min；减影法完成MPR、MIP及全脑动脉VR所需要平均的时间为15.62±3.02min；两组重建时间具有显著统计学差异(t=19.587 p=0.000)，减影CTA可显著缩短重建时间。床突以上脑动脉重建，减影组重建图像质量略逊于常规组，但评分差距无统计学意义(t=0.397,p>0.05)；床突及以下脑动脉重建，减影组重建图像质量优于常规组，评分差距有统计学意义(t=18.035,p=0.000)。常规CTA对脑动脉瘤检出总体诊断特异性为100%，敏感性为95.6%，准确性为96.8%；减影CTA检出脑动脉瘤的总体诊断敏感性为100%，特异性均92.3%，准确性为99.2%；减影CTA与常规CTA综合评价动脉瘤诊断敏感性为100%，特异性为100%，准确性为100%。结论减影CTA较常规CTA在颅底动脉瘤的诊断方面具有较大优势，减影CTA联合常规CTA综合评价颅内动脉瘤诊断敏感性、特异性、准确性均为100%，可作为临床诊断颅内动脉瘤的首选方法。
목적：평개상규CTA여감영CTA재뇌동맥류진단중적우결점。방법126례주망막하강출혈환자행CTA검사후，분별진행상규CTA중건급감영CTA중건。유영상과두경조2명부주임의사채용맹법대량조도상질량분석병진행진단。126례환자우3-72소시내행금표준DSA검사혹개로동맥류협폐치료。결과상규법완성MPR、MIP급전뇌동맥VR소수요평균적시간위27.17±5.89min；감영법완성MPR、MIP급전뇌동맥VR소수요평균적시간위15.62±3.02min；량조중건시간구유현저통계학차이(t=19.587 p=0.000)，감영CTA가현저축단중건시간。상돌이상뇌동맥중건，감영조중건도상질량략손우상규조，단평분차거무통계학의의(t=0.397,p>0.05)；상돌급이하뇌동맥중건，감영조중건도상질량우우상규조，평분차거유통계학의의(t=18.035,p=0.000)。상규CTA대뇌동맥류검출총체진단특이성위100%，민감성위95.6%，준학성위96.8%；감영CTA검출뇌동맥류적총체진단민감성위100%，특이성균92.3%，준학성위99.2%；감영CTA여상규CTA종합평개동맥류진단민감성위100%，특이성위100%，준학성위100%。결론감영CTA교상규CTA재로저동맥류적진단방면구유교대우세，감영CTA연합상규CTA종합평개로내동맥류진단민감성、특이성、준학성균위100%，가작위림상진단로내동맥류적수선방법。
Objective To evaluate the advantages and disadvantages of the conventional CTA method with subtraction CTA in the diagnosis of cerebral aneurysms. Methods A total of 126 patients diagnosed of subarachnoid hemorrhage underwent CTA examination, respectively for conventional CTA reconstruction and subtraction CTA reconstruction. Record the reconstruction time, image quality assessment, 2 associate chief physician diagnosed two groups of image quality analysis and using blind method. 126 patients from 3 to within 72 hours of gold standard DSA examination or craniotomy and aneurysm clipping treatment. Results the routine method to complete the MPR, MIP and total cerebral artery VR needed the average time is (27.17+5.89) min;subtraction method to complete the MPR, MIP and total cerebral artery VR needed the average time is (15.62+ 3.02) min; two groups of reconstruction time with significant statistical difference (t=19.587 p=0.000), subtraction CTA could significantly shorten the reconstruction time. The cerebral artery reconstruction, the reconstructed image quality of subtraction group was less than that of routine group, but the score disparity had no statistical significance (t=0.397, p>0.05); reconstruction and the following cerebral arterial bed process, the quality of reconstruction image subtraction group is better than the conventional group, there is statistical significance score gap (t=18.035, p=0.000). Conventional CTA in cerebral aneurysm detection overall diagnostic specificity is 100%, the diagnostic sensitivity was 95.6%, the accuracy rate was 96.8%, the overall diagnostic sensitivity of CTA subtraction detection of cerebral aneurysms was 100%, the overall specificity 92.3%, the accuracy rate was 99.2%; the reduction of comprehensive evaluation of shadow CTA and conventional CTA diagnosis of intracranial aneurysm, the sensitivity was 100% and a specificity of 100%, accuracy of 100%. Conclusion CTA has more advantages than conventional subtraction CTA in diagnosis of basicranial aneurysms, less comprehensive evaluation of shadow CTA combined with conventional CTA in diagnosis of intracranial aneurysms sensitivity, specificity and accuracy were 100%, the preferred method for clinical diagnosis of intracranial aneurysm.