| Objective:To evaluate the value of 64-slice CT angiography(CTA)in the diagnosis of focal lesions in patients with spontaneous subarachnoid hemorrhage compared with brain digital subtraction angiography(DSA)as a control group.Materials and Methods:The imaging and related medical history data on 111 cases of spontaneous subarachnoid hemorrhage with CTA and DSA examinations from February 2013 to November 2017 in the Department of Neurology of the First People’s Hospital of Jishou University were retrospectively analyzed.From the following three aspects of analysis:(1)Responsible intracranial aneurysms detected by DSA were used as controls,and the total number of responsible aneurysms,location,tumor length,tumor width,and neck width were used as samples to evaluate the diagnosis of CTA.There is no statistical difference in the rate of output.(2)Aneurysms were measured at the same angle on CRT Volume Rendering(VR)and 3D-DSA images.DSA measurement was used as the gold standard to compare the two measurements on the tumor and neck measurements.difference.(3)The diagnostic efficacy of CTA and responsible aneurysm was evaluated by using the measured length,width,and neck width of the aneurysm as samples.Results:In 111 patients with DSA,96 patients with positive aneurysm were detected and 115 aneurysms were detected.Among the negative patients,10 patients with Perimesencephalic Subarachnoid Hemorrhage(PMSAH)were considered for diagnosis.CTA detected a total of 81 aneurysms in 111 patients and 86 positive patients.There were 4 cases of false positives with aneurysms detected by CTA and aneurysms detected by CTA.CTA had a sensitivity of 84.4%,a specificity of 73.3%,a false positive rate of 26.7%,and a false negative rate of 12.5%.The difference was not statistically significant(P>0.05).CTA and DSA were found in the aneurysm.The consistency of the detection rate is higher.The measurements of the long diameter of the aneurysm by CTA and DSA(x±s,mm)were 4.71 ± 2.34 mm and 4.63 ± 2.30 mm,respectively;the difference was not statistically significant(P>0.05);and the width of the tumor was(x±s),mm)were 3.85±1.66 mm,3.65±1.66 mm,respectively,the difference was not statistically significant(P>0.05);the measurement of neck width of the aneurysm(x±s,mm)was 3.47±1.45 mm,2.70±1.13,respectively.Mm,the difference was statistically significant(P<0.05).Conclusion:(1)The sensitivity and specificity of detection of >3mm intracranial aneurysms by 1 and 64 rows of CTA were good,but there was still a gap between the diagnostic rate of arterial pain <3mm and 3D-DSA,so CTA could be used as suspected intracranial The preferred method of examination for patients with spontaneous subarachnoid hemorrhage in aneurysms,but DSA is still required for further confirmation of diagnosis in patients with unexplained negative SAH.(2)The measurement of the maximum diameter of intracranial aneurysms is more accurate for CTA,but the measured value for the aneurysm neck is significantly larger than that of DSA,which has statistical difference.Accurate measurement of the neck of the neck still requires a DSA check.(3)CTA on the aortic aneurysm of the skull base artery such as ophthalmic artery,cerebellar artery display effect is poor,easy to missed diagnosis,the need for DSA to provide more accurate information for clinical diagnosis and treatment. |
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