Comparison of CTA and CTPa in diagnosis of cerebral vascular stenosis and occlusive diseases / 实用放射学杂志

ABSTRACT

Objective The original data of CT perfusion(CTP) using 320-row area detector can reconstruct the whole-brain dynamic CT perfusion-derived angiography (CTPa).To confirm whether CTPa could replace CTA in diagnosis of cerebral vascular stenosis and occlusive diseases.Methods Thirty-five patients undergoing CTA and CTPa were screened retrospectively for this study.The image quality,display of fine intracranial vascular,vascular enhancement CT value,SNR and CNR were compared from the same patient.Using DSA imaging as the golden standard,the Sn and Sp for detecting the vessel segments stenosis ≥50％ or occlusion were compared for two examinations.Results CTPa showed higher image quality score,vascular enhancement CT value,SNR and CNR than CTA (P＜0.001).CTPa was superior to CTA in the display of fine intracranial vascular.The Sn and Sp for detecting the vessel segments stenosis ≥50％ or occlusion were 88.57％ and 99.26％ with CTA,91.42％ and 99.75％ with CTPa respectively(P＞ 0.05).Conclusion Compared with CTA,CTPa provides better image quality and comparable vascular pathology.CTPa is expected to replace CTA in diagnosis of cerebral vascular stenosis and occlusive diseases.