摘要
目的：评价双源CT双能量直接去骨血管成像（DE-CTA）诊断颈内动脉颅内段动脉瘤的价值。材料与方法：2008年6~12月共24例患者进行了DE-CTA和DSA检查。利用直接能量减影处理后的数据重组容积再现数据，同时将能量平均后数据进行常规CTA重组。分别由2名经验丰富的放射科医生独立评价所有患者颈内动脉颅内段DE-CTA的图像质量、动脉瘤的有无，出现动脉瘤时记录其数目、大小和瘤颈，并与DSA结果进行对照。结果：2例患者各1条颈内动脉闭塞，1例患者因延迟时间差错2条血管显影较差（1分），其余44条血管均可满足影像学评价。以DSA为参照标准，常规CTA检出了46条血管共有23个动脉瘤，漏诊了3个，而DE-CTA检出了全部26个动脉瘤。以DSA为参照标准，常规CTA和DE-CTA诊断颅内动脉瘤的敏感性分别为88.5%和100%。DE-CTA测量的动脉瘤平均瘤颈与最大径分别为（3.5±1.3）mm、（6.7±5.1）mm，与DSA测量值之间[瘤颈（3.4±1.3）mm、最大径（6.9±5.2）mm）]有较好的相关性（r=0.565，P=0.015；r=0.979，P=0.000）。结论：DE-CTA能有效去除骨结构，显示颅内段颈内动脉，在诊断该处动脉瘤方面有很高的诊断准确性，值得在临床推广应用。
Abstract
Objective: To evaluate the clinical value of dual energy bone removal CT angiography(DE-CTA) for the diagnosis of intracranial internal carotid artery aneurysms. Materials and Methods: Twenty-four patients underwent DE-CTA and DSA between Jun. 2008 and Dec. 2008. Image post-processing of DE-CTA and routine CTA was performed using the dedicated software. Two well-experienced radiologists evaluated image quality of DE-CTA and presence of aneurysms, number, aneurysm neck and maximal dimension were recorded. Comparable study was performed with DSA, the gold standard. Results: Four vessels were non-evaluable because of occlusion(n=2) and poor image quality resulting from imperfect delayed time(n=2); while the remaining 44 vessels had evaluable image quality. With DSA as the reference of standard, routine CTA and DE-CTA detected 23 and 26 aneurysms, respectively, corresponding to sensitivities of 88.5% and 100%. Mean and maximal diameter of aneurysm neck were (3.5±1.3)mm and (6.7±5.1)mm, with a good correlation with DSA[aneurysm neck, (3.4±1.3)mm; maximal diameter, (6.9±5.2)mm]; (r=0.565, P=0.015; r=0.979, P=0.000). Conclusions: DE-CTA can remove bone in the skull base and visualize the intracranial internal carotid artery with a high diagnostic sensitivity for detection of intracranial aneurysms of internal carotid artery. The technique of DE-CTA should be widely used in the routine clinical practice.
关键词
颅内动脉瘤 /
体层摄影术 /
螺旋计算机 /
血管造影术 /
数字减影
Key words
Intracranial aneurysm /
Tomography /
spiral computed /
Angiography /
digital subtraction
张龙江;赵艳娥;柴 学;周长圣;郑 玲;卢光明.
双源CT双能量直接去骨血管成像诊断颈内动脉颅内段动脉瘤并与DSA对照[J]. 中国临床医学影像杂志. 2009, 20(8): 603-606
ZHANG Long-jiang;ZHAO Yan-e;CHAI Xue;ZHOU Chang-sheng;ZHENG Ling;LU Guang-ming.
Dual energy bone removal CT angiography for the diagnosis of intracranial internal carotid artery aneurysms: comparison with digital subtraction angiography[J]. Journal of China Clinic Medical Imaging. 2009, 20(8): 603-606
中图分类号：
Ｒ739.41
Ｒ814.42
Ｒ814.4
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