MSCTA与DSA对蛛网膜下腔出血病因的诊断  

Etiological Imaging Diagonis of SAH with MSCTA and DSA

作　　者：金国宏[1] 陈兵[1] 王爱军[1] 马淑琴[2] 李云香[1] 赵俊玲[1] 

机构地区：[1]宁夏医学院附属医院放射科,宁夏750004 [2]宁夏医学院附属医院门诊内科,宁夏750004

出　　处：《放射学实践》2006年第6期549-552,共4页Radiologic Practice

摘　　要：目的:探讨多层螺旋CT三维血管成像(3DMSCTA)作为自发性蛛网膜下腔出血首选病因诊断方法的临床价值。方法:回顾搜集了2002年1月至2005年3月自发性蛛网膜下腔出血患者71例,均行数字减影血管造影(DSA)检查和多层螺旋CT血管造影检查,比较二种影像学方法的优缺点。结果:71例中,DSA发现动脉瘤58例,其中发生在颈内动脉床突上段3例,前交通支20例,大脑前动脉2例,后交通支23例,基底动脉5例,大脑中动脉主干侧裂分叉部3例,多发小动脉瘤2例;动静脉畸形6例;动静脉畸形合并动脉瘤3例;静脉性血管异常2例;阴性2例。3DMSCTA检出大小动脉瘤61个,显示瘤体、瘤颈、载瘤动脉和与周围血管及颅骨的关系清晰、确切。显示畸形血管团的部位大小,供血动脉来源,引流静脉的分支情况,空间立体结构清晰。71例DSA检查者,CTA诊断符合者67例;2例MSCTA发现动脉瘤,DSA检查阴性;MSCTA漏诊2例;2例经CT平扫显示有蛛网膜下腔出血,而MSCTA与DSA均无阳性发现。所有患者中29例行血管内栓塞治疗,手术治疗35例,内科保守治疗7例。结论:3DMSCTA检查诊断蛛网膜下腔出血性疾病的敏感性高,是一种安全、无创、简便、快速、准确的诊断方法。Objective.. To compare the accuracy of 3D MSCTA and DSA in the etiological diagnosis of spontaneous subarachnoid hemorrhage （SAH）. Methods .. Performance of 3D MSCTA and DSA in the etiological diagnosis of 71 cases of spontaneous SAH were reviewed retrospectively and compared. Results： With DSA, 58 patients were found had aneurysm, 6 had AVM,3 had AVM with aneurysm,2 had malformation of veins and 2 were negative. Etiological diagnoses of MSCTA were consistent with that of DSA in 67 patients. As for the remaining 4 patients,2 aneurysms detected by 3D MSCTA were missed with DSA while 2 aneurysms found with DSA were missed with 3D MSCTA. Conclusion.. 3D MSCTA has a similar accuracy in the etiological diagnosis of spontaneous SAH to DSA.

关 键 词：体层摄影术 X线计算机 血管造影术 数字减影 蛛网膜下腔出血 

分 类 号：R816.1[医药卫生—放射医学]