CT 血管造影、T2 加权 MRI 和磁共振血管造影在检测脑动静脉畸形及相关动脉瘤中的敏感性。
Sensitivity of CT angiography, T2-weighted MRI, and magnetic resonance angiography in detecting cerebral arteriovenous malformations and associated aneurysms.
机构信息
Department of Neurological Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
出版信息
J Clin Neurosci. 2012 Aug;19(8):1093-5. doi: 10.1016/j.jocn.2011.11.021. Epub 2012 Jun 15.
An increasing number of patients with arteriovenous malformations (AVM) are being screened with expedient, safe, and non-invasive methods such as computed tomography angiography (CTA), MRI, and magnetic resonance angiography (MRA). Only a paucity of small series have examined the sensitivity of these modalities in detecting AVMs. In this study, we reviewed 125 patients with AVMs, demonstrating overall sensitivities of 90% for CTA, 89% for T2-weighted MRI, and 74% for MRA. The greater sensitivity of CTA in detecting AVMs compared to MRA did meet statistical significance (p(CTA, MRA)=0.036). For unruptured AVMs, the sensitivities were 96%, 97% and 71% (p(CTA, MRA)=0.043) and for ruptured AVMs, they were 87%, 83% and 77%, respectively. The sensitivity was 100% for both CTA and T2-weighted MRI for AVMs larger than 3 cm. Importantly, associated aneurysms were best detected via CTA, with a sensitivity of 88%, as compared to 29% for MRI and 27% for MRA (p(CTA, MRA)=1.2×10(-6)), with the greatest distinction occurring within the subgroup of intranidal aneurysms with a sensitivity of 83% for CTA compared to 0% for both MRI and MRA (p(CTA, MRA)=0.005).
越来越多的动静脉畸形（AVM）患者正在接受快速、安全、非侵入性的方法进行筛查，如计算机断层血管造影（CTA）、磁共振成像（MRI）和磁共振血管造影（MRA）。只有少数小系列研究检查了这些方法在检测 AVM 中的敏感性。在这项研究中，我们回顾了 125 例 AVM 患者，CTA 的总体敏感性为 90%，T2 加权 MRI 为 89%，MRA 为 74%。CTA 检测 AVM 的敏感性高于 MRA，这具有统计学意义（p(CTA, MRA)=0.036）。对于未破裂的 AVM，敏感性分别为 96%、97%和 71%（p(CTA, MRA)=0.043），对于破裂的 AVM，敏感性分别为 87%、83%和 77%。对于大于 3 厘米的 AVM，CTA 和 T2 加权 MRI 的敏感性均为 100%。重要的是，通过 CTA 可以最好地检测到伴发的动脉瘤，敏感性为 88%，而 MRI 为 29%，MRA 为 27%（p(CTA, MRA)=1.2×10(-6)），差异最大的是位于颅内动脉瘤亚组，CTA 的敏感性为 83%，而 MRI 和 MRA 的敏感性均为 0%（p(CTA, MRA)=0.005）。
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