Vieco P T, Shuman W P, Alsofrom G F, Gross C E
Department of Radiology, University of Vermont Medical Center Hospital, Burlington 05401, USA.
AJR Am J Roentgenol. 1995 Aug;165(2):425-30. doi: 10.2214/ajr.165.2.7618571.
The purpose of this study was to compare CT angiography with digital subtraction angiography (DSA) in the detection and measurement of intracranial aneurysms in patients with acute subarachnoid hemorrhage.
Thirty consecutive patients with recent subarachnoid hemorrhage shown by unenhanced CT scanning or lumbar puncture were studied with CT angiography and DSA. Using a shaded surface display format and source images, two reviewers working independently blindly interpreted CT angiograms for presence and size of aneurysms. Sensitivity and specificity for aneurysm detection were calculated for each reviewer. Aneurysm size measurements were compared between reviewers and between the two imaging techniques.
Thirty aneurysms were found in 22 patients with DSA; eight patients had no aneurysms. The sensitivity and specificity of CT angiography for reviewer A were 0.97 and 1.0, respectively. For reviewer B, the sensitivity and specificity were 0.77 and 0.87, respectively. All cases with single aneurysms on DSA (18 patients) had surgical confirmation of aneurysm location and rupture. In each case with multiple aneurysms (four patients), the aneurysm thought responsible for the hemorrhage was surgically confirmed. In those cases with no aneurysms found on DSA, follow-up DSA studies did not reveal additional findings. Differences between reviewers in aneurysm size measurements made with CT angiography were not significant (p = .10). Mean aneurysm measurements for reviewer A, reviewer B, and DSA were 6.6 mm, 7.0 mm, and 6.9 mm, respectively.
CT angiography shows potential in the detection and measurement of aneurysms in patients with acute subarachnoid hemorrhage when compared with DSA.
本研究旨在比较CT血管造影与数字减影血管造影（DSA）在急性蛛网膜下腔出血患者颅内动脉瘤检测和测量中的应用。
对30例经非增强CT扫描或腰椎穿刺显示近期蛛网膜下腔出血的连续患者进行CT血管造影和DSA检查。两位独立工作的审阅者使用表面阴影显示格式和源图像，对CT血管造影进行盲法解读，以确定动脉瘤的存在和大小。计算每位审阅者检测动脉瘤的敏感性和特异性。比较审阅者之间以及两种成像技术之间的动脉瘤大小测量结果。
DSA在22例患者中发现30个动脉瘤；8例患者未发现动脉瘤。审阅者A的CT血管造影敏感性和特异性分别为0.97和1.0。审阅者B的敏感性和特异性分别为0.77和0.87。所有DSA显示单个动脉瘤的病例（18例患者）均经手术证实动脉瘤的位置和破裂情况。在每例多个动脉瘤的病例（4例患者）中，经手术证实了被认为是出血原因的动脉瘤。在DSA未发现动脉瘤的病例中，随访DSA检查未发现其他异常。审阅者之间用CT血管造影测量的动脉瘤大小差异无统计学意义（p = 0.10）。审阅者A、审阅者B和DSA测量的动脉瘤平均大小分别为6.6 mm、7.0 mm和6.9 mm。
与DSA相比，CT血管造影在急性蛛网膜下腔出血患者动脉瘤的检测和测量中显示出潜力。
