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山东大学学报(医学版)

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三维DSA与二维DSA在颅内动脉瘤诊疗中应用价值的比较

宁丹,李彩霞,李春海   

  1. 山东大学齐鲁医院介入科, 济南 250012
  • 收稿日期:2007-12-11 修回日期:1900-01-01 出版日期:2008-04-16 发布日期:2008-04-16
  • 通讯作者: 李彩霞

Comparison of 2D-and 3D-digital subtraction angiography inevaluation of intracranial aneurysms

NING Dan, LI Cai-xia, LI Chun-hai   

  1. Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, China
  • Received:2007-12-11 Revised:1900-01-01 Online:2008-04-16 Published:2008-04-16
  • Contact: LI Cai-xia

摘要: 目的探讨三维数字减影血管造影(3D-DSA)在颅内动脉瘤诊疗中的价值及其与二维数字减影血管造影(2D-DSA)相比的优势。方法对53例因蛛网膜下腔出血(SAH)入院而CT疑诊为颅内动脉瘤的患者同时进行2D-DSA和3D-DSA检查,分别阅片并记录动脉瘤的检出情况、瘤颈显示情况、瘤体与载瘤动脉的关系及对比剂用量和X线照射剂量,对其结果进行比较分析。结果53例患者中2D-DSA诊断46例共49枚动脉瘤,占84.5%(49/58),诊断的阳性率为86.8%(46/53),灵敏度为92%,特异度为81.8%;3DDSA诊断50例共58枚动脉瘤,占100%(58/58),诊断的阳性率为94.3%(50/53),灵敏度和特异度均为100%。2D-DSA检出的动脉瘤中,清楚显示瘤颈者23枚,清楚显示瘤体与载瘤动脉关系者22枚;3D-DSA组清楚显示瘤颈者58枚,清楚显示瘤体与载瘤动脉关系者56枚(P<0.05)。53例患者行2DDSA检查平均所接受的辐射剂量及对比剂用量分别为(178.32±17.39) mGy和(74.57±11.95)mL,行3D-DSA检查则为(99.81±9.48)mGy和(54.15±7.05)mL(P<0.05)。结论3D-DSA能更清晰地显示瘤颈及瘤体与载瘤动脉的关系,提供血管内治疗的最佳工作角度,并能明显减少造影剂的用量和X线辐射剂量,提高了放射防护的安全性。

Abstract: To evaluate the 3D-digital subtraction angiography (DSA) and 2D-DSA in diagnosis of intracranial aneurysms. Method Both 3D-DSA and 2D-DSA were performed on 53 patients with subarachnoid hemorrhage(SAH) suspected as cerebra1 aneurysms by CT. Results In the 2D-DSA group, the accurate rate, positive rate, sensitivity and specificity were respectively 84.5% (49/58), 86.8%(46/53), 92%, and 81.8%. In the 3D-DSA group, the accurate rate and positive rate were 100%(58/58) and 94.3%(50/53), and the sensitivity and specificity were both 100%. By 2D-DSA, 23 cases of neck of aneurysm were clearly showed, and 22 cases were surely displayed the source vessel, however, by 3D-DSA, 58 cases of neck of aneurysm and 56 cases of source vessels were clearly showed, the difference between 2D- and 3D-DSA was significant(P<0.05). The mean radiation dose and contrastmedium of 2D-DSA were (178.32±17.39) mGy and (74.57±11.95)mL, while those of 3DDSA were (99.81±9.48) mGy and (54.15±7.05) mL, the difference between the two groups was also significant(P<0.05). Conclusions The neck of aneurysm and source vessel are more clearly in 3DDSA than in 2D-DSA,also the radiation and contrastmedium dose are much lower in 3D-DSA than in 2D-DSA.

Key words: Intracranial aneurysm, Imaging, threedimensional, Cerebral angiography

中图分类号: 

  • R739.41
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