多层螺旋CT血管造影在急性自发性颅内出血中的应用价值  

Clinical Application of Multi-slice Spiral CT Angiography in Acute Spontaneous Intracranial Hemorrhage

作　　者：王土兴[1] 毛志豪[1] 华晓[1] 毛其华[1] 

机构地区：[1]浙江省嘉兴市第一医院放射科,浙江嘉兴314000

出　　处：《实用放射学杂志》2007年第2期175-177,共3页Journal of Practical Radiology

摘　　要：目的探讨多层螺旋CT血管造影(MSCTA)在急性自发性颅内出血中的应用价值。方法CT诊断急性自发性颅内出血41例,其中蛛网膜下腔出血29例、脑内血肿12例,采用容积重建(VR)和最大密度投影(MIP)方法进行MSCTA检查,并对7例颅内动脉瘤钛夹夹闭术病例和2例脑动静脉畸形、1例脑动静脉畸形伴巢内动脉瘤手术切除病例进行术后MSCTA评价。结果41例急性自发性颅内出血中,MSCTA检查出颅内动脉瘤11例、脑动静脉畸形4例、脑动静脉畸形伴巢内动脉瘤1例;MSCTA对动脉瘤的瘤体大小、瘤颈、载瘤动脉和脑动静脉畸形的部位、大小、瘤巢的形态、供血动脉和引流静脉的显示均较清楚。7例动脉瘤行钛夹夹闭术和2例脑动静脉畸形、1例脑动静脉畸形伴巢内动脉瘤行手术切除,手术所见与术前MSCTA表现相符;术后行MSCTA复查,显示夹闭动脉瘤之钛夹位置正常,载瘤动脉、颅内大血管通畅,脑动静脉畸形之瘤巢已切除。结论MSCTA是急性自发性颅内出血病因诊断的一种无创伤、快捷有效的影像学方法,并且在颅内动脉瘤、脑动静脉畸形术后评价方面也具有临床应用价值。Objective To discuss the clinical application of multi - slice spiral CT angiography （ MSCTA ） in acute spontaneous intraeranial hemorrhage . Methods 41 cases of acute spontaneous intraeranial hemorrhage diagnosed with CT （ including subaraehniod cavity hemorrhage 29, intra -cerebral hematomas 12 ）were examined with MSCTA, the techniques of volume rendring （ VR ） and maximum intensity projection （MIP） were used. 7 cases of intracranial aneurysm closed by titanic clamp , 2 cases of cerebral arteriovenous malformation （ AVM ） and one case of AVM treated by intra - zest aneurysm excision, the post - operative MSCTA examination were received. Results 11 cases of intra- cerebral aneurysm, 4 cases of cerebral AVM and 1 case of AVM with intra -zest aneurysm were found among the 41 cases of acute spontaneous intraeranial hemorrhage. MSCTA clearly demonstrated the size, neck and artery of aneurysms as well as the location, size , zest shape, artery and vein of AVM. Pre -operative MSCTA findings of 7 cases of intracranial ancurysm clapped by titanic clap ,2 cases of cerebral AVM and 1 case of AVM treated by intra - zest aneurysm excision were confirmed with the operative findings. Post - operative MSCTA showed that the clamp location was normal; arteries were passable; zests of AVM were excised. Conclusion MSCTA is a non - injured, rapid and effective way to find the cause of acute spontaneous intraeranial hemorrhage. It also has clinical application of post - operatiove assessment for intracranial aneurysm and cerebral AVM.

关 键 词：颅内出血 自发性 血管造影术 体层摄影术 X线计算机 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R814.43[医药卫生—临床医学]