摘要
目的评估头颅数字化摄影(DR)平片在颅内动脉瘤弹簧圈栓塞术后随访中的应用价值。方法选取2022年1月~2025年1月于我院接受弹簧圈栓塞治疗的颅内动脉瘤患者109例,于出院3个月及以上返院复查,均完成头颅DR平片、计算机断层血管造影(CTA)及数字减影血管造影(DSA)检查。以DSA检查结果为诊断“金标准”,判定动脉瘤复发情况;采用Kappa一致性检验分析DR、CTA与DSA诊断结果的一致性,采用卡方检验比较DR与CTA诊断效能的差异。结果109例患者均顺利完成各项检查。DSA检出动脉瘤复发10例、未复发99例;头颅DR检出复发7例、未复发102例;头颅CTA检出复发7例、未复发102例。Kappa一致性检验结果显示,DR与DSA诊断的一致性几乎完美(κ=0.809);CTA与DSA诊断的一致性为良好水平(κ=0.682)。对DR与CTA的诊断敏感度、符合率、误诊率及漏诊率进行比较,差异均无统计学意义(P>0.05)。结论头颅DR平片与CTA在颅内动脉瘤弹簧圈栓塞术后随访中,与金标准DSA的诊断结果均具有较强一致性;且DR兼具操作便捷、成本低廉、无金属伪影干扰的优势,可作为术后中长期随访的一线筛查手段。
Objective To evaluate the application value of cranial digital radiography(DR)plain films in the follow-up of patients after intracranial aneurysm coil embolization.Methods A total of 109 patients with intracranial aneurysms who underwent coil embolization in our hospital from Jan 2022 to Jan 2025 were enrolled.All patients returned to the hospital for reexamination at least 3 months after discharge,and completed cranial DR plain film,computed tomography angiography(CTA)and digital subtraction angiography(DSA)examinations.With DSA results as the diagnostic gold standard,the recurrence of aneurysms was determined.Kappa consistency test was used to analyze the consistency of diagnostic results between DR,CTA and DSA,and Chi-square test was used to compare the differences in diagnostic efficacy between DR and CTA.Results All 109 patients successfully completed all examinations.DSA detected 10 cases of aneurysm recurrence and 99 cases of non-recurrence;cranial DR detected 7 cases of recurrence and 102 cases of non-recurrence;cranial CTA detected 7 cases of recurrence and 102 cases of non-recurrence.Kappa consistency test results showed that the consistency between DR and DSA for recurrence diagnosis reached a near-perfect level(κ=0.809),while the consistency between CTA and DSA was at a good level(κ=0.682).There were no statistically significant differences between DR and CTA in terms of diagnostic sensitivity,accordance rate,misdiagnosis rate and missed diagnosis rate(P>0.05).Conclusion Both cranial DR plain films and CTA have strong consistency with the gold standard DSA in the follow-up after intracranial aneurysm coil embolization.In addition,DR has the advantages of convenient operation,low cost and no interference from metal artifacts,and thus can be used as a first-line screening tool for medium-and long-term postoperative follow-up.
作者
孙异春
刘远来
何咏超
张晓峰
Sun Yichun;Liu Yuanlai;He Yongchao;Zhang Xiaofeng(Department of Neurosurgery,Xiaolan People's Hospital(Zhongshan Fifth People's Hospital),Zhongshan 528415)
出处
《中国现代医药杂志》
2025年第12期62-66,共5页
Modern Medicine Journal of China
基金
中山市社会公益与基础研究项目(编号:2021B1106)。
关键词
颅内动脉瘤
数字化摄影
计算机断层血管造影
脑血管造影
诊断价值
Intracranial aneurysm
Digital radiography
Computed tomography angiography
Digital subtraction angiography
Diagnostic value
