Abstract:

Objective　To explore and analyze the accuracies and imaging characteristics of CT angiography (CTA) and digital subtraction angiography (DSA) in diagnosing cerebral arteriovenous malformations (AVM). Methods　The clinical data of 40 patients with AVM admitted to Tongchuan People's Hospital from January 2019 to December 2023 were retrospectively analyzed, including 31 males and 9 females, aged 35-73 years. All patients underwent CTA and DSA examinations, and the imaging characteristics of the two examination methods were compared. Meanwhile, the diagnostic accuracies and misdiagnosis rates of the two examination methods were compared with the postoperative pathological results as the gold standard. The spatial relationships between the two techniques on blood supply arteries, drainage veins, and intracranial aneurysms were observed. χ² test and t test were used. Results　CTA and DSA were relatively clear in the detection of lesions, and there was no statistically significant difference in the diagnosis of malformed vascular mass between the two methods (χ²=0.966, P=0.616). With postoperative pathological results as the gold standard, all patients could see clear supplying arteries, with 116 supplying arteries and 73 draining veins; DSA examination showed that the diagnostic accuracies of supplying arteries and draining veins were 100.00% (116/116) and 97.26% (71/73), which were higher than 97.41% (113/116) and 93.15% (68/73) of CTA, but the difference was not statistically significant (χ²=0.037, P=0.981). The clear rates of spatial relationship of intracranial aneurysms showed by DSA and CTA were 82.50% (33/40) and 85.00% (34/40), respectively, without statistically significant difference (χ²=0.214, P=0.898). The diagnostic accuracy and misdiagnosis rate of DSA for cerebral AVM were 92.50% (37/40) and 7.50% (3/40), respectively, while those of CTA were 87.50% (35/40) and 12.50% (5/40), respectively, without statistically significant difference (χ²=0.555, P=0.456). Conclusions　Considering the advantages and disadvantages of CTA and DSA, the diagnosis of malformed vascular mass in CTA and DSA is basically the same. CTA can be used as the first non-invasive method for diagnosis. If the diagnostic detection rate needs to be further improved, a combined scheme can be adopted to reduce diagnostic errors as much as possible, which is worthy of clinical attention.

Key words:

Cerebral arteriovenous malformations, CT angiography, Digital subtraction angiography, Blood supply artery examination, Imaging features

摘要：

目的　探究分析CT血管造影（CTA）、数字减影血管造影（DSA）诊断脑动静脉畸形的准确性及影像学特征。方法　本研究为回顾性分析。选取2019年1月至2023年12月铜川市人民医院收治的40例脑动静脉畸形患者临床资料，其中男31例，女9例，年龄35～73岁。所有患者均行CTA、DSA检查，比较两种检查方式的影像学特征；以术后病理结果为金标准，比较两种检查方式的诊断准确率及误诊率，观察两种技术对供血动脉和引流静脉、颅内动脉瘤空间关系的显示情况。采用χ²检验、t检验进行统计分析。结果　CTA、DSA对40例脑动静脉畸形患者病灶的检查均相对清晰，两种检查方式的畸形血管团诊断结果差异无统计学意义（χ²=0.966，P=0.616）。以术后病理结果为金标准，所有患者均能见到明确的供血动脉，供血动脉数116条，引流静脉数73条，DSA检查结果显示供血动脉和引流静脉的诊断准确率分别为100.00%（116/116）、97.26%（71/73），CTA检查结果分别为97.41%（113/116）、93.15%（68/73），差异无统计学意义（χ²=0.037，P=0.981）。DSA、CTA颅内动脉瘤的空间关系显示清晰度分别为82.50%（33/40）、85.00%（34/40），差异无统计学意义（χ²=0.214，P=0.898）；DSA对脑动静脉畸形的诊断准确率、误诊率分别为92.50%（37/40）、7.50%（3/40），CTA的诊断准确率、误诊率分别为87.50%（35/40）、12.50%（5/40），差异无统计学意义（χ²=0.555，P=0.456）。结论　综合CTA、DSA两者优缺点，CTA、DSA畸形血管团诊断基本相同，CTA可作为脑动静脉畸形诊断的首选无创方案，如需进一步提高诊断准确率，则可采用联合方案，从而尽可能减少诊断差错，值得临床重视。

关键词:

脑动静脉畸形, CT血管造影, 数字减影脑血管造影, 供血动脉检查, 影像学特征