Li Qi, Lv Fajin, Yao Guoen, Li Yongmei, Xie Peng
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, PR China.
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, PR China.
Acta Radiol. 2014 Sep;55(7):840-6. doi: 10.1177/0284185113506138. Epub 2013 Sep 24.
To assess the diagnostic performance of 64-section computed tomography angiography (CTA) for detection of cerebral aneurysms by comparison with the new gold standard three-dimensional (3D) digital subtraction angiography (DSA).
A total of 128 patients who underwent both 64-section CTA and 3D DSA for suspected intracranial aneurysms were included. The location, size, and shape of the aneurysm were assessed and compared with 3D DSA results. The sensitivity, specificity, positive and negative predictive values of 64-section CTA were calculated by using 3D DSA as reference standard.
According to the reference standard, a total of 145 aneurysms were detected at 3D DSA in 118 patients. Of these 145 aneurysms, 64-section CTA detected 139 aneurysms in 118 patients. The sensitivity of CTA for detection of aneurysm was 95.8% on a per-aneurysm basis. All missed aneurysms were non-causative very small aneurysms in patients harboring multiple aneurysms. On a per-patient basis, the sensitivity, specificity, positive and negative predictive values were 100%.
Compared with the new gold standard 3D DSA, 64-section CTA offers high sensitivity and specificity for detection of intracranial aneurysms. It could be readily used as a screening imaging method for detection of intracranial aneurysms.
通过与新的金标准三维（3D）数字减影血管造影（DSA）相比较，评估64层计算机断层血管造影（CTA）检测脑动脉瘤的诊断性能。
纳入128例因疑似颅内动脉瘤同时接受64层CTA和3D DSA检查的患者。评估动脉瘤的位置、大小和形态，并与3D DSA结果进行比较。以3D DSA作为参考标准，计算64层CTA的敏感性、特异性、阳性和阴性预测值。
根据参考标准，118例患者在3D DSA检查中共检测到145个动脉瘤。在这145个动脉瘤中，64层CTA在118例患者中检测到139个动脉瘤。CTA检测动脉瘤的动脉瘤层面敏感性为95.8%。所有漏诊的动脉瘤均为多发性动脉瘤患者中无病因的非常小的动脉瘤。在患者层面，敏感性、特异性、阳性和阴性预测值均为100%。
与新的金标准3D DSA相比，64层CTA检测颅内动脉瘤具有较高的敏感性和特异性。它可作为一种易于使用的颅内动脉瘤筛查成像方法。
