本文選題：顱內(nèi)動脈瘤 + 256層三維CT血管造影�。� 參考：《吉林大學(xué)》2013年碩士論文

【摘要】：目的： 以三維數(shù)字減影血管造影為金標(biāo)準(zhǔn)，探討256層三維CT血管造影診斷顱內(nèi)動脈瘤的價值。 方法： 收集我院2010年10月-2012年12月43例蛛網(wǎng)膜下腔出血并同時行3D-CTA與3D-DSA檢查的病例。 1、以3D-DSA為金標(biāo)準(zhǔn)，評價3D-CTA的敏感性，特異性，陽性預(yù)測值，陰性預(yù)測值。并比較3D-CTA與3D-DSA在動脈瘤的檢出率上有無統(tǒng)計學(xué)差異。 2、以3D-DSA造影測量結(jié)果為金標(biāo)準(zhǔn)，比較3D-CTAVR與3D-DSAVR以及二者與3D-DSA造影比較在測量動脈瘤瘤頸及動脈瘤瘤體長徑方面的差異。 3、以3D-DSA為金標(biāo)準(zhǔn)，比較3D-CTA與3D-DSA在動脈瘤瘤頸顯示的清晰度方面有無差異。 結(jié)果： 以動脈瘤數(shù)目計算，3D-CTA的敏感性為90.2%，≤3mm的動脈瘤的敏感性85.7%，3mm的動脈瘤敏感性為95.0%。以病例數(shù)計算，3D-CTA的敏感性、特異性、陽性預(yù)測值、陰性預(yù)測值分別為91.6%、85.7%、97.0%、66.7%。3D-CTA與3D-DSA在顱內(nèi)動脈瘤檢出率方面差異無統(tǒng)計學(xué)意義。3D-CTA與3D-DSA造影圖像在瘤頸與瘤體長徑測量方面P0.05，差異無統(tǒng)計學(xué)意義。3D-CTA與3D-DSA(VR)在動脈瘤瘤頸及瘤體長徑測量方面,P0.05，，差異有統(tǒng)計學(xué)意義。3D-DSA(VR)與3D-DSA造影圖像在瘤頸與瘤體長徑測量方面P0.05，差異有統(tǒng)計學(xué)意義。3D-CTAVR與3D-DSAVR在顯示動脈瘤瘤頸及載瘤動脈清晰度方面差異有統(tǒng)計學(xué)意義。 結(jié)論： 1、3D-CTA與3D-DSA在總體動脈瘤的檢出率上差異無統(tǒng)計學(xué)意義，因此3D-CTA可以替代3D-DSA進(jìn)行顱內(nèi)動脈瘤的術(shù)前診斷。 2、3D-CTAVR所測的數(shù)值可以用于術(shù)前動脈瘤瘤頸及瘤體長徑的測量，而3D-DSAVR所測數(shù)值偏大，因此在使用3D-DSAVR測量動脈瘤瘤頸及瘤體長徑時應(yīng)考慮這方面的因素。 3、對于3D-CTAVR未能清晰顯示的動脈瘤瘤頸及載瘤動脈要進(jìn)一步行3D-DSA檢查。
[Abstract]:Objective: Using three dimensional digital subtraction angiography as gold standard, the value of 256 slice CT angiography in the diagnosis of intracranial aneurysms was discussed. Methods: From October 2010 to December 2012, 43 cases of subarachnoid hemorrhage were examined by 3D-CTA and 3D-DSA. 1. Using 3D-DSA as gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of 3D-CTA were evaluated. To compare the difference between 3D-CTA and 3D-DSA in the detection rate of aneurysm. 2. According to the results of 3D-DSA, the difference between 3D-CTAVR and 3D-DSAVR and between 3D-CTAVR and 3D-DSA in measuring the length and diameter of aneurysm neck and aneurysm was compared. 3. Using 3D-DSA as the gold standard, the difference between 3D-CTA and 3D-DSA in the definition of aneurysm neck was compared. Results: According to the number of aneurysms, the sensitivity of 3D-CTA was 90.2, the sensitivity of aneurysms 鈮

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