| PART 1 THE STUDY OF VALUE AND FACTORS AFFECTED EFFICIENCY OF VCTDSA IN DIAGNOSIS OF INTRACRANIAL ANEURYSM PurposeExplore the value of VCTDSA in diagnosis of intracranial aneurysm by comparing with 3D-DSA.MethodsThe clinial data,VCTDSA and 3D DSA data were analyzed retrospectively in 204 patients with SAH. The number,position,size of intracranial aneurysm, and intracranial vascular condition, effect of skull removal were measured. The sensitivity,specificity,positive predictive value and negative predicitive value of VCTDSA in aneurysm detecting were calculated, and possible factors that affect diagnostic efficiency of VCTDSA were analyzed.Results246 aneurysms were detected by 3D-DSA in 178 patients, 248 aneurysms were detected by VCTDSA in 180 patients, there were 119multi-aneurysms in 51 patients.The sensitivity, specificity,positive predictive value and negative predicitive value of VCTDSA in detection of aneurysm in number were 99.2%,84.6%, 98.4%, 91.7%, respectively.The sensitivity of VCTDSA was 96.7% for aneurysm less than 3mm,and 100%for those were more than 3mm.VCTDSA missed 2 aneurysms due to vasospasm and anatomical variations of their parent arteries,and misdiagnosed 4 aneurysms due to head movement, vasospasm and partial volume effect. 3D DSA missed 2 aneurysms due to hemodynamic abnormal of the aneurysms and their parent arteries.ConclusionThere is no statistical significance between VCTDSA and 3D-DSA in detection of aneurysm.Anatomical variations of parent arteries、size of the aneurysm 、 vasospasm and head movement during the examination can affect the efficiency of VCTDSA in the diagnosis of intracranial aneurysms.PART 2 COMPARATIVE STUDY OF VCTDSA AND 3D-DSA ON MEASUREMENT OF INTRACRANIAL ANEURYSM PurposeExplore the difference between VCTDSA and 3D-DSA in measurement of intracranial aneurysm.MethodsThe clinial data,VCTDSA and 3D DSA data were analyzed retrospectively in 165 patients with 210 aneurysm,which the aneurysms could be found in the two methods in part one. The difference between these two methods of measured value about aneurysmal length and width,length of aneurysmal neck,diameter of parent artery and AR/SR value was compared respectively.Results210 aneurysms were detected by VCTDSA and 3D-DSA in 165 patients.There was apparent correlation of all the value measured by VCTDSA and 3D-DSA(r=0.99,0.99,0.86,0.81).The mean value of aneurysmal length 、 width and diameter of parent arterymeasured by VCTDSA and 3D-DSA was 4.89 ± 3.1mm vs 4.88 ± 3.1mm, 4.59 ±3.37 mm vs 4.6±3.34 mm, and.09±0.93 mm vs 3.01±0.88 mm,,with no statistical difference(t=1.03、-0.23、1.93,P=0.3、0.81、0.056).The mean value of aneurysmal neck width measured by VCTDSA and 3D-DSA was4.11 ± 1.58 mm vs 3.87 ± 1.53 mm, with significant statistical difference(t=4.23,P<0.01).Mean value of AR calculated from VCTDSA and 3D-DSA was 1.19±0.57 vs 1.26±0.6,with significant statistical difference(t=-3.3,P=0.01).But there is no statistical difference between the mean value of SR calculated from VCTDSA and 3D-DSA(1.7±1.31 vs 1.72±1.07,t=-0.67,P=0.48)).ConclusionThere is no statistical significance between VCTDSA and 3D-DSA in measurement of aneurysmal length, width, diameter of aneurysmal neck and parent artery.Nevertheless, it’s a little more great in value of diameter of aneurysmal neck measured by VCTDSA,the difference would not take a role in chose of operative plan. VCTDSA is effective enough in dsecribing the morphology feature of cerebral aneurysm. |
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