自发性蛛网膜下腔出血后不同危险级别患者脑血管痉挛的MSCTA评价  

The diagnostic value of multi-modality CT in spontaneous subarachnoid hemorrhage

作　　者：杨运俊[1] 张明升[2] 陈伟建[1] 梁盼[1] 赵兵[2] 钟鸣[2] 谭显西[2] 

机构地区：[1]温州医学院附属第一医院放射影像中心,浙江温州325000 [2]温州医学院附属第一医院神经外科,浙江温州325000

出　　处：《温州医学院学报》2011年第4期343-345,共3页Journal of Wenzhou Medical College

基　　金：浙江省医药卫生科技计划资助项目(2008B129);温州市科技局对外合作项目(H20090012)

摘　　要：目的:探讨自发性蛛网膜下腔出血(SAH)后不同危险级别患者的脑血管痉挛(CVS)程度是否存在差异。方法:对32例SAH患者进行低、高危险级别分组后,与多层螺旋CT血管成像(MSCTA)评价的CVS程度进行比较,所有病例均经数字减影血管造影(DSA)证实。结果:本组32例患者中,低危险级别25例,高危险级别7例,发生CVS患者12例(占37.5%)。25例低危级别患者中,18例(占72%)MSCTA表现正常,7例(占28.0%)出现轻度CVS,多无临床体征;7例高危级别患者中,2例(占28.6%)MSCTA表现正常,5例(占71.4%)出现中重度CVS,临床表现为迟发性缺血性神经功能缺失。低、高危险级别患者与MSCTA检出的CVS程度比较,Z=-2.936,P<0.05。结论:MSCTA可准确无创地评价SAH后CVS程度,指导临床分组治疗。Objective： To explore the difference of intracranial vasospasm（CVS）caused by the spontaneous subarachnoid hemorrhage（SAH） for different risk rank patients.Methods： Multi-section CT angiography（MSCTA）was performed in 32 patients with SAH who initiailly divided into low-and high-risk rank groups.The relationship between degrees of CVS and different risk rank patients was studied.MSCTA was compared with digital subtraction angiography（DSA） for the detection and characterization of vasospasm on intracranial arterial segments.Results： Among the 32 patients,there were 25 low-risk rank patients,7 high-risk rank patients,and 12（37.5%）patients with CVS.In 25 low-risk rank cases,18 cases were normal and 7 showed mild CVS on MSCTA,and there was no evident clinical sympotoms.In 7 high-risk rank cases,2 cases were normal and 5 showed mid-and severe-CVS on MSCTA.The significance between degrees of CVS and risk rank patients was different（Z=-2.936,P0.05）.Conclusion：MSCTA is an accurate,reliable,and noninvasive technology.It can be used to identify the degree of CVS after SAH and instruct clinical treatment for different risk rank patients.

关 键 词：体层摄影术 X线计算机 蛛网膜下腔出血 血管痉挛 

分 类 号：R743.35[医药卫生—神经病学与精神病学]