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目的探讨多层螺旋CT血管造影(CTA)在蛛网膜下腔出血(SAH)病因诊断中的临床应用价值。方法对2008年1月到2011年2月收治入院的56例SAH患者行多层螺旋CT血管造影检查,其中52例同时接受数字减影血管造影(DSA)检查。分析CTA检查结果并与DSA检查结果比较。结果 56例患者中CTA检出动脉瘤43例,动静脉畸形(AVM)5例,静脉窦血栓3例,阴性5例;在同时接受DSA检查的患者中,发现动脉瘤45例,AVM5例,阴性1例,其中除1例CTA发现并经临床证实的动脉瘤DSA检查为阴性外,其余全部证实CTA诊断。CTA对SAH病因诊断中的敏感性和特异性都为95.8%,DSA分别为98%和100%。结论多层螺旋CTA对SAH的病因诊断是一种无创、快速、便捷的影像学检查方法,其脑血管立体成像技术对自发性蛛网膜下腔出血的病因诊断准确性高,可显示血管的空间立体结构及周边关系,有助于临床手术治疗方法的选择和难度的评估,可作为急诊SAH的首选检查方法。
Objective To investigate the clinical value of multi-slice spiral CT angiography (CTA) in the diagnosis of subarachnoid hemorrhage (SAH). Methods From January 2008 to February 2011, 56 cases of SAH admitted to hospital underwent multislice spiral CT angiography, of which 52 cases underwent digital subtraction angiography (DSA). Analyze CTA results and compare with DSA results. Results Among the 56 patients, 43 aneurysms were detected in CTA, 5 were AVM, 3 were sinus thrombosis and 5 were negative. Among the patients who received DSA at the same time, 45 aneurysms, 5 AVMs, Negative in 1 case, except for 1 case of CTA found clinically confirmed aneurysm DSA negative, the rest all confirm the CTA diagnosis. The sensitivity and specificity of CTA for the diagnosis of SAH were 95.8% and DSA were 98% and 100% respectively. Conclusions MSCT is a noninvasive, rapid and convenient method for the diagnosis of SAH. Cerebral vascular stereotactic imaging has high diagnostic accuracy for etiological diagnosis of spontaneous subarachnoid hemorrhage. It can show the vascular space Three-dimensional structure and the relationship between the periphery, contribute to the choice of clinical surgical treatment methods and the difficulty of assessment, can be used as the first choice for emergency SAH examination.