Comparison Study Of MRA And DSA In Diagnosis Of Intracranial Aneurysms

Objectives:Through the analysis of intracranial aneurysms in 3D TOF-MRA, CE-MRA and DSA onimaging findings, evaluate the advantages and disadvantages of 3D TOF-of MRA, theCE-MRAand DSA on the diagnosis of intracranial aneurysms. Explore Application value of 3DTOF-of MRA, the CE-MRA and DSA in the clinical diagnosis of intracranial aneurysms.Methods:Collecting 38 cases From March 2011 to January 2012 who are highly suspected ofintracranial aneurysm patients, including 23 cases of female, male 15 cases, age 23 to 74 yearsold, the average age of 52.6 years old. Firstly the patients were examined by 3D TOF-MRA andCE-MRA of GE signalExeiteHo 1.5T MR superconducting magnetic resonance scanner, whichboth are non-invasive examination. The head of Patients with supine position was fixed. Thetotal of 8highly suspected patients with intracranial aneurysm were firstly detected by 3 DTOF-MRA.Then all patients were detected by CE-MRA after injecting Gd-DTPA contrast agents,and detected by DSA in the last. (1)Comparing with standard diagnosis of intracranial aneurysms,we analyzed the sensitivity, specificity, accuracy of 3D TOF-MRA、CE-MRA and DSA On thediagnosis of intracranial aneurysms .(2)Comparing the3-D imaging capabilities of 3DTOF-MRA, CE-MRA and DSA. (3)Comparing the display capabilities of 3D TOF-MRA,CE-MRA and DSA on the intracranial aneurysms combined hemorrhage and thrombus in theaneurysm sac.Results(1)The results of 38 highly suspected of intracranial aneurysm patients:detected 31 cases ofpositive,38 cases of aneurysm. (2)In 3D TOF-MRA, there are detected 26 cases of positive and30 cases of aneurysms. Among these 26 cases,23 cases were ture positive ,3 cases were faslepositive and 8 cases were false negative. The sensitivity, specificity and the accuracy rating ofTOF-MRA were 57.14%、74.23%、71.05% respectively. In CE-MRA, there are detected 29 casesof positive and 33 cases of aneurysms. Among these 29 cases,28 cases were ture positive ,1 caseswere fasle positive and 3 cases were false negative. The sensitivity, specificity and the accuracyrating of CE-MRA were 90.32%、85.71%、89.47% respectively. In DSA, there are detected 30cases of positive and 34 cases of aneurysms. Among these 30 cases,30 cases were ture positive ,0cases were fasle positive and 1 cases were false negative. The sensitivity, specificity and the accuracy rating of DSA were 96.77%、100.00%、97.36% respectively. Based on statisticalanalysis ,the sensitivity and accuracy rating of DSA and CE-MRA are higher than 3DTOF-MRA（p＜0.05）.The difference about the three methods’s specificity have nostatisticallsignificant（p＞0.05）.(3) Among the 30 cases aneurysms of 3D TOF-MRA, 24 ca sesclearly showed the 3-D shapes and spatial relation and 6 cases were not cleal; Among the 33cases aneurysms of CE-MRA, 28 cases clearly showed the 3-D shapes and spatial relation and 5cases were not cleal; Among the 34 cases aneurysms of 2D-DSA, 19 cases clearly showed the3-D shapes and spatial relation and 15 cases were not cleal; Based on statistical analysis, 3DTOF-MRA and CE-MRA were superior to 2D-DSA on displaying the 3-D shape and spatialrelations（p＜0.05）.(4) 4 cases combining hemorrhage lesions in TOF- MRA were notdetected. CE-MRA and DSA were detected accurately. Among 7 thromboses in aneurysmsacs, 3 cases were demonstrated to be artifact. There were 4 thromboses in the aneurysm sacswere correctly detected by CE–MRA and 2 cases were correctly detected by DSA.Conclusion1. CE-MRA、DSA were batter than 3D TOF-MRA on diagnosis of intracranialaneurysms,CE-MRA to make up for defects of 3D TOF-MRA on blood factors and improvethe sensitive and accuracy of the diagnosis of intracranial aneurysms, as a noninvasivescreening method, can be used for the screening of intracranial aneurysms.2. 3D TOF-MRA and CE-MRA were better than 2D-DSA on showing the 3-D shape andspatial structure of aneurysms. Combined with a variety of post-processing technology ofCE-MRA, the 3-D shape and spatial structure of aneurysms were able to display better.3. The diagnosis of aneurysm combining hemorrhage and thromboses, CE-MRA better thanTOF-MRA and DSA.