3D—CTA在自发性蛛网膜下腔出血早期诊治中的价值（附616例报告）  

The value of three -dimensional computed tomographic angiography in the early diagnosis and treatment of spontaneous subarachnoid hemorrhage （ 616 cases report ）

作　　者：石鑫[1] 栾新平[3] 买买提力[1] 郝玉军[1] 成晓江[1] 刘波[1] 柳琛[1] 杨文[2] 刘文亚[2] 

机构地区：[1]新疆医科大学第一附属医院神经外科,乌鲁木齐830054 [2]新疆医科大学第一附属医院影像中心,乌鲁木齐830054 [3]新疆医科大学第二附属医院神经外科

出　　处：《中华神经外科杂志》2011年第3期296-299,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨3D-CTA在自发性蛛网膜下腔出血诊断和治疗中的应用价值.方法 采用3D-CTA检查自发性蛛网膜下腔出血患者616例,根据造影结果决定是否手术,部分患者进一步查3D-DSA血管造影.结果 592例患者共发现640个动脉瘤,23例查3D-CTA及3D-DSA均未发现动脉瘤.3D-DSA发现1例漏诊的动脉瘤.3D-CTA在估计动脉瘤大小及形态方面与术中＋3D-DSA结果相似.3D-CTA清晰显示了动脉瘤的自身形态和周边的关系.结论 3D-CTA是诊治颅内动脉瘤的一种快捷、安全、操作简便的方法.为制定手术方案提供了详细的资料,具有很高的临床实用价值.Objective To evaluate the clinical value of three - dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage.Method 616 cases were diagnosed as suspected intracranial aneurysms in 3D - CTA system.Computed tomographic scans and CTA studies were first reviewed by the treating surgeon, along with neuroradiologist and a decision to proceed to 3D - DSA or directly to surgery was made on the basis of the type and quality of information provided by CTA.Results In 23 patients, both 3 D - CTA and 3 D - DSA were negative for a source of subarachnoid hemorrhage.640 Intracranial aneurysms was identified in 592 patients.There was an excellent correlation between aneurysms size assessed using 3D - CTA and that determined by 3D - DSA and the operation.That method displayed great accuracy in characterizing the morphological characteristics of the aneurysm.Conclusions Three - dimensional CT angiography is a quick, reliable and relatively noninvasive method for diagnosing intracranial aneurysms.It delineates detailed aneurismal morphology, and provides useful information for planning microsurgical approaches.

关 键 词：蛛网膜下腔出血 颅内动脉瘤 CT血管造影 手术夹闭 血管造影术 数字 减影 

分 类 号：R743.34[医药卫生—神经病学与精神病学]