From the Departments of Interventional Radiology (W.H.C., Z.M.H., C.Y.W., Q.W.), Radiology (W.X.), and Neurosurgery (Y.P.), the Third Affiliated Hospital of Suzhou University, 185 Juqian St, 213003 Changzhou, China.
Radiology. 2013 Dec;269(3):841-9. doi: 10.1148/radiol.13130191. Epub 2013 Oct 28.
To assess the accuracy of 320-detector row nonsubtracted and subtracted volumetric computed tomographic (CT) angiography for detection of cerebral aneurysms.
After institutional review board approval and informed written consent were obtained, 282 consecutive patients suspected of having cerebral aneurysms underwent CT angiography with a 320-detector row volumetric CT scanner and three-dimensional (3D) rotational digital subtraction angiography (DSA). The sensitivity, specificity, and accuracy of nonsubtracted and subtracted volumetric CT angiography for depiction of aneurysms were analyzed, with 3D DSA as the reference standard. P values less than .05 were considered to indicate a significant difference.
Among the 282 patients, 198 (70.2%) had 239 cerebral aneurysms that were detected on the basis of 3D DSA. Nonsubtracted volumetric CT angiography showed 231 of the 239 (96.7%) aneurysms. The primary reason for missed aneurysms was close proximity to bone tissue. Sensitivity, specificity, and accuracy of nonsubtracted volumetric CT angiography for depicting aneurysms were 96.7%, 100%, and 97.5%, respectively, on a per-aneurysm basis. Subtracted volumetric CT angiography showed 237 of 239 (99.2%) aneurysms. Sensitivity, specificity, and accuracy of subtracted volumetric CT angiography for depicting aneurysms were 99.2%, 100%, and 99.4%, respectively, on a per-aneurysm basis. There was no statistically significant difference in accuracy between subtracted volumetric CT angiography and 3D DSA (P = .500). However, nonsubtracted volumetric CT angiography was significantly less sensitive than 3D DSA and subtracted volumetric CT angiography (P = .031 and .008, respectively).
Subtracted 320-detector row volumetric CT angiography provides excellent sensitivity for detection of cerebral aneurysms and should be the first-line imaging technique for the noninvasive evaluation of aneurysms. The accuracy of nonsubtracted volumetric CT angiography was lower than that for subtracted volumetric CT angiography, especially for aneurysms adjacent to bone tissue.
评估 320 排非减影和减影容积 CT 血管造影术检测脑动脉瘤的准确性。
本研究经机构审查委员会批准，并获得了书面知情同意，连续 282 例疑似脑动脉瘤的患者接受了 320 排容积 CT 扫描仪和三维（3D）旋转数字减影血管造影（DSA）的 CT 血管造影检查。以 3D DSA 为参考标准，分析非减影和减影容积 CT 血管造影术对动脉瘤的检出的敏感性、特异性和准确性。P 值小于 0.05 为差异有统计学意义。
在 282 例患者中，198 例（70.2%）患者共发现 239 个脑动脉瘤，均基于 3D DSA 确诊。非减影容积 CT 血管造影术显示了 231 个动脉瘤。漏诊动脉瘤的主要原因是临近骨组织。非减影容积 CT 血管造影术对动脉瘤的检出的敏感性、特异性和准确性分别为 96.7%、100%和 97.5%。减影容积 CT 血管造影术显示了 237 个动脉瘤。减影容积 CT 血管造影术对动脉瘤的检出的敏感性、特异性和准确性分别为 99.2%、100%和 99.4%。减影容积 CT 血管造影术和 3D DSA 的准确性无统计学差异（P=0.500）。然而，非减影容积 CT 血管造影术的敏感性明显低于 3D DSA 和减影容积 CT 血管造影术（P=0.031 和 0.008）。
减影 320 排容积 CT 血管造影术对脑动脉瘤的检测具有很高的敏感性，应该作为非侵入性评估动脉瘤的首选成像技术。非减影容积 CT 血管造影术的准确性低于减影容积 CT 血管造影术，特别是对临近骨组织的动脉瘤。
