| Objective Comparative analysis of the value of 256-slice CTA and DSA in the early diagnosis of hemorrhagic cerebrovascular disease provides guidance for clinical examination of hemorrhagic cerebrovascular disease.Methods A total of 86 patients with hemorrhagic cerebrovascular disease diagnosed in the Department of Neurosurgery of Affiliated Hospital of Youjiang Medical College for Nationalities from January 2017 to December 2018 were collected.All patients were examined by 256-slice CTA and DSA within 24 hours after admission.Using hospital medical image transmission system,all CTA and DSA images were read by experienced radiologists and neurosurgical interventional specialists in a double-blind way,and the diagnostic items needed to be compared and analyzed were identified:(1)Were there intracranial aneurysms,cerebral arteriovenous malformations,moyamoya disease;(2)The location of intracranial aneurysms was recorded and the diameter of aneurysm body and neck was measured;(3)Recorded the location of the founding arteriovenous malformations and moyamoya disease.Statistical analysis was performed using SPSS 17.0 software.Results Among the 86 cases of hemorrhagic cerebrovascular disease,64 cases of intracranial aneurysm,4 cases of cerebral arteriovenous malformation and 4 cases of moyamoya disease were detected by 256-slice CTA,the positive rate is 83.72%(72 / 86);66 cases of intracranial aneurysm,4 cases of cerebral arteriovenous malformation and 4 cases of moyamoya disease were detected by DSA,the positive rate is 86.05%(74 / 86),after statistical analysis,χ2=0.18,P=0.67>0.05,there is no significant difference in the detection rate of intracranial aneurysm,cerebral arteriovenous malformation and moyamoya disease between256-slice CTA and DSA in hemorrhagic cerebrovascular disease.If DSA was used as the gold standard,the detection rate of intracranial aneurysms,cerebral arteriovenous malformations and moyamoya disease was 100%,while that of 256-slice CTA was 97.30%.Statistical analysis showed that χ2=0.51,P=0.48>0.05,there is no significant difference between 256-slice CTA and DSA in 74 cases of intracranial aneurysms,cerebral arteriovenous malformations and moyamoya disease.64 cases of intracranial aneurysm were detected by 256-slice CTA,there were 3 cases of anterior cerebral aneurysm,13 cases of middle cerebral aneurysm,2 cases of posterior cerebral aneurysm,19 cases of anterior communicating artery aneurysm,11 cases of posterior communicating artery aneurysm,14 cases of internal carotid artery ophthalmic aneurysm and 2 cases of vertebrobasilar aneurysm.DSA detected 66 cases of intracranial aneurysms,including 3 cases of anterior cerebral artery aneurysm,13 cases of middle cerebral artery aneurysm,2 cases of posterior cerebral artery aneurysm,21 cases of anterior communicating artery aneurysm,11 cases of posterior cerebral aneurysm,14 cases of internal carotid artery-ocular artery aneurysm and 2 cases of vertebral basilar artery aneurysm.There is no significant difference in the location of the detected intracranial aneurysms between the 256-slice CTA and the DSA,Kappa ≥ 0.75 by Kappa test,and the results of the two examination methods are in good agreement.The diameters of all intracranial aneurysms detected by 256-slice CTA and DSA were compared,and the diameters of aneurysm body and neck of different sizes(diameter of aneurysm body and neck < 3 mm,diameter of aneurysm body and neck 3~5mm,diameter of aneurysm body and neck > 5mm)were compared,by statistical analysis,there is no significant statistical difference.In 74 cases of hemorrhagic cerebrovascular disease,4 cases of cerebral arteriovenous malformations and 4 cases of moyamoya disease could be detected by 256-slice CTA and DSA,the detection rate is 100% and kappa > 0.75,the results of the two methods are in good agreement.Conclusion There is no significant difference in the detection of intracranial aneurysm,cerebral arteriovenous malformation and moyamoya disease between 256-slice CTA and DSA in hemorrhagic cerebrovascular disease,the possibility of missed diagnosis is very small;Compared with the position of the intracranial aneurysm detected by the 256-slice CTA and the DSA,the results of the two examination methods are in good agreement,and the difference in the diameter of aneurysm body and neck is not statistically significant,so 256-slice CTA can diagnose intracranial aneurysms early;The results of 256-slice CTA and DSA are in good agreement with each other in the detection of cerebral arteriovenous malformations and moyamoya disease.Considering the complexity,invasiveness,high risk and high cost of DSA examination compared with CTA examination,DSA examination also causes medical staff and patients to be exposed to radiation and cause iatrogenic injury.Therefore,we believe that 256-slice CTA examination,as an early examination of hemorrhagic cerebrovascular disease,has certain advantages over DSA,and is of great help in the early etiological diagnosis of hemorrhagic cerebrovascular disease,and may replace DSA examination in the early etiological diagnosis of hemorrhagic cerebrovascular disease. |
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