二次造影对首次造影阴性的自发性蛛网膜下腔出血的价值  

Value of Repeated Cerebral Angiography for Patients of Spontaneous Subarachnoid Hemorrhage with Initial Negative Angiogram

作　　者：吴贤群[1] 林立[1] 袁邦清[1] 郑林丰[2] 

机构地区：[1]中国人民解放军第四七六医院,福建福州350002 [2]上海交通大学附属第一人民医院放射科,上海200080

出　　处：《现代生物医学进展》2012年第30期5851-5854,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨二次造影对首次血管造影阴性的自发性蛛网膜下腔出血(Subarachnoid hemorrhage,SAH)的价值。方法:回顾性分析2009年7月至2011年7月我院共收治的自发性蛛网膜下腔出血患者115例,在确诊蛛网膜下腔出血后1-3天行股动脉插管全脑血管造影并3D重建和颅脑CT平扫。首次DSA结果阴性者于2-8周行二次全脑血管造影。结果:115例中83例共发现颅内动脉瘤87个,9例为脑血管畸形、Moyamoya病等,23例首次造影阴性。但23颅脑CT显示弥漫性蛛网膜下腔出血16例,中脑周围蛛网膜下腔出血5例,局限于一个脑池或脑叶内蛛网膜下腔出血1例,颅脑CT阴性1例。二次造影后在16例弥漫性蛛网膜下腔出血患者中共发现动脉瘤3例。结论:二次造影对首次血管造影阴性的自发性蛛网膜下腔出血患者具有较高的临床意义,尤其是对于首次造影高度怀疑动脉瘤的弥漫性蛛网膜下腔出血患者,进行二次造影是必要的。Objective： To investigate the value of repeated cerebral angiography for patients of spontaneous subarachnoid hemorrhage with initial negative angiogram. Methods： 115 patients with subaraehnoid hemorrhage （SAH）were investigated in the No. 476 hospital of PLA from July 2009 to July 2011. All cases performed cerebral angiography and CT scan of head in 1-3 days after SAH. In patients with initial negative angiogram, the repeated cerebral angiography were performed. Results： In 115 cases, 87 aneurysms were present in 83 cases, 28 had malformations and moyamoya disease, 23 had negative angiogram. In 23 patients with initial negative angiogram, 16 had diffuse SAH, five had perimesencephalic SAH, one had localized SAH in one cistern or lobe ,one had no hemorrhage sign on CT. In 16 diffuse SAH cases, 3 aneurysms were present in repeated cerebral angiography. Conclusions： Repeated angiography play an important role in case of spontaneous subarachnoid hemorrhage with initial negative angiogram, especially for case with suspicion of aneurysm in initial angiography.

关 键 词：颅内动脉瘤 数字减影血管造影 蛛网膜下腔出血 

分 类 号：R743.35[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]