磁共振非对比增强血管成像与 DSA 在颅内动脉瘤诊断的对比分析

摘要

目的：以数字减影血管造影（DSA）为金标准，对比分析磁共振非对比增强血管成像（3D‐NC‐MRA ）诊断颅脑动脉瘤及其判断瘤体长度的价值。方法收集2013年9月～2014年8月临床怀疑为颅内动脉瘤的患者65例并进行3D‐NC‐MRA 及 DSA 检查，将两种方法所检查出的动脉瘤图像进行后处理并结合原始图像进行综合分析；以 DSA 为金标准对比分析3D‐NC‐MRA 所显示颅内动脉瘤结果及二者对动脉瘤瘤体长度检测的差异。结果所有患者 DSA 检出43例患者有动脉瘤共53个，其中＜3mm 共15个，≥3mm 共38个；3D‐NC‐MRA 检查发现50个动脉瘤，其中＜3mm 共10个，≥3mm 共40个；所有动脉瘤分布于后交通动脉、颈内动脉、大脑中动脉、前交通动脉、基底动脉区域；3D‐NC‐MRA对＜3mm 颅内动脉瘤的灵敏度和特异性分别为66．7％，100％，对≥3mm 的颅内动脉瘤灵敏度和特异性分别为100％，100％；对所有动脉瘤诊断的灵敏度和特异性分别为90．6％、100％。3D‐NC‐MRA 与 DSA 比较，所有颅内动脉瘤瘤体长度测量差异均无统计学意义（ P ＞0．05）。结论3D‐NC‐MRA 对颅内≥3mm 动脉瘤具有较高的检出率和准确性，可以作为临床对颅内动脉瘤的常规诊断方法。而＜3mm 动脉瘤存在一定漏诊，对于阴性发现者必要时应行 DSA 进一步检查。%Objective Taking digital subtraction angiography (DSA) as a gold standard ,we conducted a comparative a‐nalysis of the value of non‐contrast‐enhanced magnetic resonance angiography (NCE‐MRA) in the diagnosis of cerebral an‐eurysms and the judgement of the length of tumors .Methods From August 2012 to August 2014 ,65 patients with clini‐cal suspicion of intracranial aneurysm were collected and underwent NCE‐MRA and DSA examination .Data from the two methods were post‐processed and a comprehensive analysis was performed based on of the original image ;Taking DSA as the gold standard ,the contrast analysis of results from NCE‐MRA of intracranial aneurysms and the differences of the length of the aneurysm tumors were determined .Results For all suspected patients ,DSA examination detected 43 pa‐tients ,with a total of 53 aneurysms ,of which 15 were less than than 3 mm and 38 more than 3 mm ;While ,NCE‐MRA examination revealed 50 aneurysms ,of which 10 were less than than 3 mm and 40 more than 3 mm .All aneurysms were distributed the areas of posterior traffic artery ,internal carotid artery ,middle cerebral artery ,anterior traffic artery and basilar artery area .The sensitivity and specificity of NCE‐MRA the detection of intracranial aneurysm < 3 mm of sensitiv‐ity and specificity were 66 .7% ,100% ,those for the tumors ≥ 3 mm were 100% ,100% ,and those for all the aneurysms were 90 .6% ,100% respectively .Ccompared with DSA ,NCE‐MRA had no statistically significant difference in measuring the length of all intracranial aneurysm tumors ( P > 0 .05) .Conclusion NCE‐MRA for intracranial aneurysm ≥ 3 mm has higher detection rate and accuracy ,and can be used as a clinical diagnostic method for intracranial aneurysm .As for aneu‐rysms less than 3 mm ,NCE‐MRA may have misdiagnosis .In such a negative situation ,DSA should be further used if necessary .