Xiao Zebin, Zheng Yingyan, Li Jian, Chen Dehua, Liu Fang, Cao Dairong
1 Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
2 Department of Hyperbaric Oxygen Treatment, First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Dentomaxillofac Radiol. 2017 Dec;46(8):20170171. doi: 10.1259/dmfr.20170171. Epub 2017 Oct 10.
To explore the value of four-dimensional CT angiography (4D-CTA) in the preoperative evaluation of juvenile nasopharyngeal angiofibromas (JNAs) using 320-row volume CT.
4D-CTA and DSA data of 18 patients with histopathologically proven JNAs were retrospectively reviewed. The location, extent, feeding vessels and stage of JNAs were assessed by two radiologists independently and blindly. The agreements between both reviewers and between 4D-CTA and surgical findings for assessing the above indicators were analysed, respectively. The radiation dose and the number of feeding arteries between 4D-CTA and digital subtraction angiography (DSA) were also compared.
4D-CTA showed high diagnostic consistency with surgical pathology for JNAs with consistent rates of 96.2 and 100% in both reviewers, respectively. The effective dose of 4D-CTA was significantly less than that of DSA (p < 0.001). Good agreements between 4D-CTA and surgical findings and between the two reviewers were found in the assessment of the location, extent and stage of JNAs. 4D-CTA showed that 15 lesions were supplied strictly by the external carotid artery circulation and 3 by the external and internal carotid artery supply, which was in accordance with DSA. There were no significant differences in the main arterial feeder number obtained by 4D-CTA and DSA between different observers (all p > 0.05).
4D-CTA can provide a reliable preoperative diagnosis and assessment of JNAs, which is useful for determining the surgical strategy and management of this condition.
探讨320排容积CT的四维CT血管造影（4D-CTA）在青少年鼻咽血管纤维瘤（JNA）术前评估中的价值。
回顾性分析18例经组织病理学证实的JNA患者的4D-CTA和数字减影血管造影（DSA）数据。由两名放射科医生独立且盲法评估JNA的位置、范围、供血血管和分期。分别分析两位评估者之间以及4D-CTA与手术结果在评估上述指标方面的一致性。还比较了4D-CTA与DSA之间的辐射剂量和供血动脉数量。
4D-CTA对JNA的诊断与手术病理具有高度一致性，两位评估者的符合率分别为96.2%和100%。4D-CTA的有效剂量显著低于DSA（p<0.001）。在评估JNA的位置、范围和分期方面，4D-CTA与手术结果之间以及两位评估者之间具有良好的一致性。4D-CTA显示15个病灶严格由颈外动脉循环供血，3个由颈外和颈内动脉供血，与DSA结果一致。不同观察者通过4D-CTA和DSA获得的主要供血动脉数量无显著差异（均p>0.05）。
4D-CTA可为JNA提供可靠的术前诊断和评估，有助于确定该病的手术策略和治疗方案。
