Comparison of diagnostic velue of 3D-CTA and 3D-DSA in diagnosis of intracranial small aneurysms
Abstract：Objective To investigate the diagnoctic value of three-dimensional spiral CT angiography (3D-CTA) and three-dimensional digital subtraction angiography(3D-DSA) in diagnosis of intracranial small aneurysms.Methods The clinical data of 30 patients with intracranial aneurysm rupture caused by subarachnoid hemorrhage who underwent 3D-CTA and 3D-DSA examination in our hospital from January 2016 to January 2017 were retrospectively analyzed. These patients were definitely diagnosed by surgical open cranium occlusion or vascular intervention surgery,who were divided into CTA group and DSA group.The detection accuracy of two kinds of examination methods in diagnosis of intracranial small aneurysms with different sizes and in different positions was analyzed and compared between the two groups.Results Among 30 patients with intracranial small aneurysms,35 small aneurysms were found including 26 cases with single microaneurysm, 3 cases with 2 aneurysms and 1 cases with 3 small aneurysms,in which,30 small aneurysms were detected by CTA,with accuracy rate being 85.7%, and 5 small aneurysms were missed diagnosed, with false negative rate (missed diagnosis rate) being 14.3%, moreover,4 small aneurysms were false positive,with misdiagnosis rate being 10.3%. However 35 small aneurysms were detected by DSA,with accuracy rate being 100%,and false negative rate(missed diagnosis rate) was 0,and 1 small aneurysm was false positive,with misdiagnosis rate being 2. 7%. Among the missed aneurysms in CTA group, 3 microaneurysms diameter was less than 3mm(1 piece in internal carotid artery,1 piece in posterior cerebellum artery and 1 piece in posterior communicating artery),moreover,the other 2 microaneurysms diameter was between 3mm~5mm (1 piece in internal carotid artery and 1 piece in anterior communicating artery). The detection rate of 3D-CTA and 3D-DSA in diagnosis of small aneurysms (3mm ~5mm) was 92.6% and 100%,respectively,there was no significant difference in the detection rate between two detection methods (P >0.05). In addition the detection rate of 3D-CTA and 3D-DSA in diagnosis of small aneurysm (less than 3mm) was 62.5% and 100%, respectively, there was a significant difference in the detection rate between two detection methods (P <0.05). Conclusion In diagnosis of small intracranial aneurysms (3mm ~5mm), 3D-CTA is a noninvasive,fast,safe and reliable means of first choice of imaging examination, however,in diagnosis of small intracranial aneurysms (less than 3mm), 3D-CTA has higher misdiagnosis rate and missed diagnosis rate. Moreover the accuracy rate of 3D-DSA in diagnosis of intracranial small aneurysms is significantly higher than that of 3D-CTA,and 3D-DSA can provide more information for further treatment of small aneurysms.
Keywords：three-dimensional spiral CT angiographythree-dimensional digital subtraction angiographysmall aneurysmmicroaneurysm
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 698-701 )