
浏览全部资源
扫码关注微信
1.南京医科大学第一附属医院放射科,江苏 南京 210029
2.江苏省卫生健康发展研究中心,江苏 南京 210000
杨春,E-mail:yangchun277@163.com
收稿日期:2024-10-12,
纸质出版日期:2025-03-25
移动端阅览
严吉来,杨春.多层螺旋CT血管造影成像在颅脑动脉瘤诊断中的应用及影像特点分析[J].局解手术学杂志,2025,34(03):250-253.
YAN Ji-lai,YANG Chun.Application and imaging characteristics of multi-slice CT angiography in the diagnosis of cerebral aneurysm[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(03):250-253.
严吉来,杨春.多层螺旋CT血管造影成像在颅脑动脉瘤诊断中的应用及影像特点分析[J].局解手术学杂志,2025,34(03):250-253. DOI: 10.11659/jjssx.10E024036.
YAN Ji-lai,YANG Chun.Application and imaging characteristics of multi-slice CT angiography in the diagnosis of cerebral aneurysm[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(03):250-253. DOI: 10.11659/jjssx.10E024036.
目的
2
探讨多层螺旋CT血管造影成像(MSCTA)在颅脑动脉瘤(CA)诊断中的应用,并对其影像特点进行分析。
方法
2
选取南京医科大学第一附属医院收治的180例疑似CA患者作为研究对象,所有患者依次接受颅脑数字减影血管造影(DSA)、MSCTA检查。以DSA检查结果为金标准,评价MSCTA诊断CA的一致性,对CA分布的诊断符合率、瘤体最大直径及瘤颈最大宽度进行比较。
结果
2
180例疑似CA患者,经DSA检查诊断CA 174例,共检出240个动脉瘤;MSCTA检查诊断CA 168例,共检出207个动脉瘤。以DSA检查结果为金标准,MSCTA检查诊断CA的敏感度为96.55%,特异度为100%,准确度为96.67%,
Kappa
值为0.651,诊断的一致性好。经MSCTA诊断的分布于颈内动脉、椎基底动脉、大脑中动脉、颈内动脉床突、颈内动脉海绵窦段、前交通动脉和后交通动脉的CA符合率分别为81.82%、83.33%、85.71%、87.50%、86.67%、90.00%和90.00%,总体诊断符合率为86.25%。MSCTA与DSA检查所得的瘤体最大直径、瘤颈最大宽度比较,差异均无统计学意义(
P
>
0.05)。
结论
2
MSCTA对CA具有较好的诊断价值,与DSA的诊断一致性较高,可在临床推广使用。
Objective
2
To explore the application of multi-slice CT angiography (MSCTA) in the diagnosis of cerebral aneurysm (CA), and to analyze its imaging characteristics.
Methods
2
A total of 180 patients with suspected CA in the First Affiliated Hospital of Nanjing Medical University were enrolled, and all these patients underwent digital subtraction angiography (DSA) and MSCTA.Taking DSA results as the golden standard, the consistency of MSCTA in the diagnosis of CA was evaluated. The diagnostic coincidence rate of CA distribution, the maximum diameter of tumors and maximum width of tumor neck by the two methods were compared.
Results
2
In the 180 patients with suspected CA, DSA showed that there were 174 confirmed cases, including 240 aneurysms, while MSCTA showed that there were 168 confirmed cases, including 207 aneurysms.Taking DSA results as the golden standard, the s
ensitivity, specificity, accuracy and
Kappa
value of MSCTA in the diagnosis of CA were 96.55%, 100%, 96.67% and 0.651 respectively, showing good diagnostic consistency.The diagnostic coincidence rates of CA distributed in the internal carotid artery, vertebrobasilar artery, middle cerebral artery, clinoid process of internal carotid artery, cavernous sinus segment of internal carotid artery, anterior communicating artery and posterior communicating artery diagnosed by MSCTA were 81.82%, 83.33%, 85.71%, 87.50%, 86.67%, 90.00% and 90.00%, and the overall diagnostic coincidence rate was 86.25%.There was no significant difference in the maximum diameter of tumors or maximum width of tumor neck between MSCTA and DSA (
P
>
0.05).
Conclusion
2
The diagnostic value of MSCTA for CA is good, whihc has high diagnostic consistency with DSA and can be widely used in clinic.
Umana GE , Spitaleri A , Fricia M , et al . Diffuse cerebral angiomatosis associated to basilar apex aneurysm [J]. Br J Neurosurg , 2023 , 37 ( 5 ): 1215 - 1219 . doi: 10.1080/02688697.2020.1836324 http://dx.doi.org/10.1080/02688697.2020.1836324 .
李玲 , 陈子瑶 , 邱晶 . 多感官促醒在动脉瘤性蛛网膜下腔出血急性期认知功能障碍患者中的应用效果 [J]. 护理实践与研究 , 2022 , 19 ( 6 ): 862 - 865 . doi: 10.3969/j.issn.1672-9676.2022.06.017 http://dx.doi.org/10.3969/j.issn.1672-9676.2022.06.017 .
彭东 , 唐兴 , 何承勇 , 等 . MSCT与三维DSA重建成像在诊断颈内动脉瘤构型中的应用价值 [J]. 中国CT和MRI杂志 , 2020 , 18 ( 1 ): 38 - 40 . doi: 10.3969/j.issn.1672-5131.2020.01.013 http://dx.doi.org/10.3969/j.issn.1672-5131.2020.01.013 .
Heit JJ , Honce JM , Yedavalli VS , et al . RAPID aneurysm:artificial intelligence for unruptured cerebral aneurysm detection on CT angiography [J]. J Stroke Cerebrovasc Dis , 2022 , 31 ( 10 ): 1066 - 1067 . doi: 10.1016/j.jstrokecerebrovasdis.2022.106690 http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2022.106690 .
邓喜青 , 王炜 , 李一辉 , 等 . 双源双能量CTA与DSA测量颅内动脉瘤几何参数Bland-Altman一致性分析 [J]. 实用放射学杂志 , 2020 , 36 ( 12 ): 2024 - 2027 . doi: 10.3969/j.issn.1002-1671.2020.12.034 http://dx.doi.org/10.3969/j.issn.1002-1671.2020.12.034 .
中国医师协会神经介入专业委员会 , 中国颅内动脉瘤计划研究组 , 张鸿祺 , 等 . 中国颅内破裂动脉瘤诊疗指南2021 [J]. 中国脑血管病杂志 , 2021 , 18 ( 8 ): 546 - 574 . doi: 10.3969/j.issn.1672-5921.2021.08.007 http://dx.doi.org/10.3969/j.issn.1672-5921.2021.08.007 .
郭云飞 , 王新文 , 杨婷 , 等 . MSCTA三维重建诊断颅内动脉瘤与DSA的一致性研究 [J]. 中国CT和MRI杂志 , 2020 , 18 ( 4 ): 1 - 3 . doi: 10.3969/j.issn.1672-5131.2020.04.001 http://dx.doi.org/10.3969/j.issn.1672-5131.2020.04.001 .
房凌宇 , 刘祥龙 , 李燕 . 多层螺旋CT血管造影对颅内动脉瘤患者的诊断价值 [J]. 实用癌症杂志 , 2023 , 38 ( 10 ): 1729 - 1732 . doi: 10.3969/j.issn.1001-5930.2023.10.038 http://dx.doi.org/10.3969/j.issn.1001-5930.2023.10.038 .
Liu Y , Guo G , Lin Z , et al . Occlusion of the anterior cerebral artery mimicking a cerebral aneurysm:clinical presentation and literature review [J]. J Neurol Surg A Cent Eur Neurosurg , 2022 , 83 ( 6 ): 606 - 610 . doi: 10.1055/s-0040-1722272 http://dx.doi.org/10.1055/s-0040-1722272 .
Zeynal M , Yalcin A . Before emergency aneurysm surgery,CTA or DSA? A single center experience [J]. Eur Rev Med Pharmacol Sci , 2023 , 27 ( 4 ): 1522 - 1527 . doi: 10.26355/eurrev_202302_31393 http://dx.doi.org/10.26355/eurrev_202302_31393 .
Yang G , Yan C , Zhang M , et al . Application effect of multi-slice spiral CT angiography combined with MRI in the diagnosis of cerebral aneurysm [J]. Biotechnol Genet Eng Rev , 2024 , 40 ( 3 ): 2982 - 2995 . doi: 10.1080/02648725.2023.2202995 http://dx.doi.org/10.1080/02648725.2023.2202995 .
胡涛 . 多层螺旋CT血管成像技术对颅脑动脉瘤诊断及误诊漏诊分析 [J]. 山西医药杂志 , 2022 , 51 ( 21 ): 2428 - 2431 . doi: 10.3969/j.issn.0253-9926.2022.21.008 http://dx.doi.org/10.3969/j.issn.0253-9926.2022.21.008 .
高杰 , 黄贤键 , 苏高健 , 等 . 颅脑创伤性蛛网膜下腔出血合并动脉瘤的诊治分析 [J]. 中华神经外科杂志 , 2024 , 40 ( 5 ): 450 - 454 . doi: 10.3760/cma.j.cn112050-20231116-00169 http://dx.doi.org/10.3760/cma.j.cn112050-20231116-00169 .
朱君孺 , 陈宏山 . CTA与DSA在颅内动脉瘤诊断中的对比研究 [J]. 中国CT和MRI杂志 , 2022 , 20 ( 5 ): 43 - 45 . doi: 10.3969/j.issn.1672-5131.2022.05.015 http://dx.doi.org/10.3969/j.issn.1672-5131.2022.05.015 .
武玉良 , 朱玉英 , 赵孟德 , 等 . CTA与DSA诊断颅内动脉瘤的临床应用分析 [J]. 医学影像学杂志 , 2022 , 32 ( 5 ): 858 - 860 .
刘艺超 , 修良昌 , 王超 , 等 . 三维CT血管成像对颅内动脉瘤的诊断价值 [J]. 中国CT和MRI杂志 , 2023 , 21 ( 11 ): 31 - 33 . doi: 10.3969/j.issn.1672-5131.2023.11.010 http://dx.doi.org/10.3969/j.issn.1672-5131.2023.11.010 .
王大伟 , 潘博 , 顾晓艳 , 等 . CTA与DSA诊断脑动脉瘤的临床应用分析 [J]. 医学影像学杂志 , 2020 , 30 ( 8 ): 1504 - 1507 .
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621