Dual Energy Computed Tomography In The Diagnosis Of Intracranial Aneurysms

Background and purposeThis study used second-generation Siemens SOMATOM Definition Flash dual-source CT(SOMATOM Definition Flash Computed tomography).in CT angiography(computed tomographic angiography,CTA).in the diagnosis of intracranial aneurysm effect and application value,and compared with DSA,explore the inspection method is more accurate and more reasonable,and provide valuable information for the clinical treatment of the disease.Materials and MethodsJune 2013 ~ June 2015 were treated by the diagnosis of suspected intracranial aneurysms subjects 86 cases,examinationcases of DSA and DSA patients aged 32 to 75 years,mean age(54.2 ± 3.5)years,male50,females 36.Mainly in patients with subarachnoid hemorrhage(55,56.98%),sudden headache(45,46.51%),cerebral hemorrhage(24,22.09%),bleeding side oculomotor nerve palsy(16,12.79%),such as performance,and exclude iodine allergies,severe heart failure and severe liver and kidney dysfunction,all patients signed informed consent and the consent of the book.Hunt-Hess grade situation: grade 0 had 6,grade 8,grade? ?46,grade 22,grade ?? 4.All patients used DSCT and DSA examination,the DSA as the gold standard for the evaluation of intracranial aneurysms.specificity,positive predictive value and negative predictive value,compared to the aneurysm detection rate;compare CTA and DSA of different sizes in detection of tumor and tumor diameter measurement situation;to DSA as the gold standard to compare CTA and DSA for aneurysm neck display clarity.Results1.86 cases with DSA as the gold standard for diagnosis of 72,82 aneurysms were not found aneurysm 14,CTA found 66,74 aneurysms,missed six cases of eight aneurysms,false positives 2 example.Two played are means of intracranial aneurysm detection rate difference was not statistically significant(P> 0.05).2.Diagnostic efficiency: The DSA diagnostic results as the gold standard,the sensitivity of CTA diagnosis of intracranial aneurysms was 91.6%,specificity 85.7%,positive predictive value 97.0%,negative predictive value of 66.7%.To calculate the number of aneurysm,CTA diagnosis of aneurysm sensitivity of 90.2%,of which for <3mm small aneurysm,the diagnostic sensitivity was 85.7%,> 3mm aneurysm(including 3 to 5mm small aneurysms and volume of larger aneurysms)the diagnostic sensitivity was 95.0%.3.Tumor diameter measurement comparison: DSA measuring tumor diameter(5.4 ± 2.3)mm,the measurement results CTA was(5.5 ± 1.8)mm,tumor diameter difference between the two measurement methods measured not statistically significant(P> 0.05).CTA(VR)of the displayed image is not clear aneurysm in 8 cases,12 show more clearly,clear display 54.DSA shows no clear case to display clearer 12,showing a clear 62,rank sum test results show two checking means for comparing the difference was statistically significant(P <0.05).Conclusions1.DE-CTA diagnosis of intracranial aneurysms have higher sensitivity and specificity,can be used as alternative means of DSA for the preoperative diagnosis of intracranial aneurysms;and has a high correlation with aneurysm quantitative measurement results of DSA,Although DE-CTAhave a rate of misdiagnosis for small aneurysms,but overall still high the value can be used as the preferred screening tool in patients with suspected intracranial tumors;2.DE-CTA only need once enhanced scan,at the same time you can get multiple sets of image data,including boneless energy subtraction image,it is a clinically effective detection of aneurysms imaging methods beacause ofoperating non-invasive,fast,and havehigh success rate;3.DSA for aneurysm neck and parent artery display resolution significantly better than the CTA,should the latter fail to clearly show the further acceptance of DSA.