目的 比较CT血管造影术(CT angiography,CTA)与磁共振血管造影(magnetic resonance angiography,MRA)诊断动脉瘤与动脉瘤破裂的风险评估价值。方法 48例高度怀疑为颅内动脉瘤患者随机分为两组,每组24例,记为Ⅰ组和Ⅱ组,其中Ⅰ组行CTA+DSA检查,Ⅱ组行MRA+DSA检查。比较CTA及MRA对颅内动脉瘤的诊断灵敏度、诊断特异性、阳性预测值、阴性预测值及准确率。比较CTA及MRA对5 mm以上动脉瘤的诊断价值。结果 MRA诊断颅内动脉瘤的诊断灵敏度、诊断特异性、阳性预测值、阴性预测值、准确率较CTA稍低,但二者差异无统计学意义。CTA与三维增强MR血管成像(3D CE-MRA)对5 mm以上动脉瘤的诊断能力相当,但与三维时间飞跃法MR血管成像(3D TOF MRA)相比,CTA与CE-MRA的诊断灵敏度、诊断特异性、阳性预测值、阴性预测值、准确率明显较高,差异有统计学意义(P<0.05);CTA能更清楚地显示瘤颈。结论 CTA和MRA可作为诊断动脉瘤与动脉瘤破裂的风险评估的首要手段,CTA诊断的准确率及三维形态高于MRA。
Abstract
Objective To compare and contrast the value of CTA and MRA in the diagnosis of arterial tumor and risk assessment of aneurysm rupture in order to standardize aneurysm treatment.Methods Forty-eight patients with suspected intracranial aneurysms treated in our hospital between July 2015 and August 2016 were randomly and equally divided into two groups. Group Ⅰ underwent CTA+DSA examination while group Ⅱ patients underwent MRA+DSA examination. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CTA and MRA for intracranial aneurysms were compared. The value of CTA and MRA in the diagnosis of aneurysm of 5 mm was also compared.Results The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, negative predictive value and accuracy of MRI in the diagnosis of intracranial tumors were slightly lower than those of CTA, but the difference was not significant between the two groups. CTA and CE-MRA were almost equally accurate in the diagnosis of aneurysms above 5 mm, but compared with 3D TOF-MRA, the diagnostic sensitivity and specificity, positive predictive value, negative predictive value,and accuracy of CTA and CE-MRA were significantly higher. The difference was of statistical significance (P<0.05).Conclusions CTA and MRA can be used as the primary means to diagnose aneurysms and assess the risk of aneurysm rupture, but the accuracy and 3D shape of CTA are better than those of MRA.
关键词
CT血管造影术 /
磁共振血管造影 /
动脉瘤
Key words
CT angiography /
magnetic resonance angiography /
aneurysm
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