目 的 分析三维CT血管造 影 ( T h r e e - D i m e n s i o n a l C o m p u t e d Tomography Angiography，3D-CTA)与三 维数字减影血管造影(Three-Dimensional Digital subtraction angiography，3DDSA)在急性破裂性颅内动脉瘤诊断中的 价值。方法 选取我院收治的90例疑似急 性破裂性颅内动脉瘤患者纳入研究，均 行3D-CTA与3D-DSA检查，以手术病理为 “金标准”，比较3D-CTA与3D-DSA检查准 确性。结果 3D-CTA诊断急性破裂性颅内 动脉瘤灵敏度为91.46%(75/82)，特异度 87.50%(7/8)，准确性91.11%(82/90)； 3D-DSA诊断急性破裂性颅内动脉瘤 灵敏度为98.78%(81/82)，特异度 100.00%(8/8)，准确性98.89%(89/90)， Kappa值均＞0.4；3D-DSA检查方式灵敏度 与准确性均明显高于3D-CTA检查方式(P ＜0.05)。结论 相较于3D-CTA，3D-DSA诊 断急性破裂性颅内动脉瘤具有较高准确 性，可为患者临床诊治提供可靠参考依 据。

Objective To analyze the value of three-dimensional computed tomography angiography (3D-CTA) and three-dimensional digital subtraction angiography (3DDSA) in the diagnosis of acute ruptured intracranial aneurysms. Methods A total of 90 patients with suspected acute ruptured intracranial aneurysms were enrolled into the study. All of them were examined by 3D-CTA and 3D-DSA. With surgical pathology as the golden standard, the accuracy was compared between 3D-CTA and 3D-DSA. Results The sensitivity, specificity and accuracy of 3D-CTA in the diagnosis of acute ruptured intracranial aneurysms were 91.46% (75/82), 87.50% (7/8) and 91.11% (82/90), respectively, while those of 3D-DSA were 98.78% (81/82), 100.00% (8/8) and 98.89% (89/90), respectively. The Kappa values were larger than 0.4. The sensitivity and accuracy of 3D-DSA were obviously higher than those of 3D-CTA (P<0.05). Conclusion Compared with 3D-CTA, 3D-DSA is of high accuracy in the diagnosis of acute ruptured intracranial aneurysms, and it can provide a reliable reference for clinical diagnosis and treatment.