1.5T 3D―TOF―MRA与DSA诊断颅内动脉瘤研究价值对比.docVIP

1.5T 3D―TOF―MRA与DSA诊断颅内动脉瘤的研究价值对比 　　摘 要：目的 探讨三维时间飞跃法磁共振血管成像（3D-TOF-MRA）与数字减影血管造影（DSA）诊断颅内动脉瘤的研究价值。方法 收集20例经DSA及手术确诊为颅内动脉瘤患者，术前均行MRA及DSA检查。MRA检查后经MRP、MIP及VR法重建并与DSA结果进行对比。结果 20例患者DSA检查出23个动脉瘤，MRA VR重建检查出21个动脉瘤，检出率为91.30%，MPR及MIP检查出20个，检出率为87.00%。结论 1.5T 3D-TOF-MRA对颅内动脉瘤有较高的敏感性和准确性，为临床诊断及治疗提供了详细的参考价值，但对于微小动脉瘤存在一定的漏诊现象，应选择DSA进行进一步检查。 　　关键词：颅内动脉瘤；核磁共振；三维时间飞越法血管成像；数字血管成像 　　中图分类号：R739.41 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.052 　　文章编号：1006-1959（2018）07-0150-03 　　Comparison of the Value of 1.5T 3D-TOF-MRA and DSA in Diagnosing Intracranial Aneurysms 　　LAN Ying-yong 　　（Department of Radiology，the Second Affiliated Hospital of Guangxi University of Science and Technology， 　　Liuzhou 545000，Guangxi，China） 　　Abstract：Objective To evaluate the value of three-dimensional time leaps magnetic resonance angiography（3D-TOF-MRA）and digital subtraction angiography（DSA）in the diagnosis of intracranial aneurysms.Methods 20 patients with intracranial aneurysms confirmed by DSA and operation were examined by MRA and DSA before operation.After MRA examination，the results were compared with the results of MRP，MIP，and VR and the results of DSA.Results In 20 patients，23 aneurysms were detected by DSA， and 21 aneurysms were detected by MRA VR reconstruction.The detection rate was 91.30%，and 20 were detected by MPR and MIP. The detection rate was 87.00%.Conclusion 1.5T 3D-TOF-MRA has high sensitivity and accuracy for the diagnosis and treatment of intracranial aneurysms，which provides a detailed reference for clinical diagnosis and treatment.However，there is a certain missed diagnosis for small aneurysms.DSA should be further examined. 　　Key words：Intracranial aneurysm；Nuclear magnetic resonance；Three-dimensional time-of-flight imaging；Digital angiography 　　自?l性蛛网膜下腔出血（subarachnoid hemorrhage，SAH）最主要的原因是颅内动脉瘤破裂，占全部蛛网膜下腔出血病例的80.00%，其致死率及致残率高达30%～45%和50%[1]，选择最合适的影像学检查方法并尽早及时治疗是挽救患者生命的关键。数字减影血管造影（digital subtraction angiography，DSA）是诊断颅内动脉瘤金标准，但其有侵入性、辐射性、相对昂贵及形成动脉夹层并发症等缺点，不适用于所