3D-DSA在蛛网膜下腔出血首次脑血管造影阴性中的作用  

Application of three-dimensional digital subtraction angiography in subarachnoid hemorrhage with negative initial angiography

作　　者：刘伟[1] 郭庆东[1] 付洛安[1] 张磊[1] 胡世颉[1] 费舟[1] 

机构地区：[1]第四军医大学西京医院神经外科,陕西西安710032

出　　处：《中华神经外科疾病研究杂志》2015年第1期12-14,共3页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探讨自发性蛛网膜下腔出血(SAH)首次全脑血管造影阴性的原因及三维数字减影血管造影(3D-DSA)在再次造影中的作用。方法回顾性分析本院2009至2012年自发性蛛网膜下腔出血首次造影结果呈阴性的63例患者,其中62例遵医嘱第二次行3D-DSA检查,1例等待复查期间再出血死亡。结果其中5例复查发现颅内动脉瘤,4例给予血管内介入治疗,1例因动脉瘤微小观察随访治疗。结论血管痉挛、微小动脉瘤是SAH首次造影阴性的重要原因,SAH的患者首次造影阴性应重复血管造影检查,3D-DSA在复查中起重要作用。Objective The cause of spontaneous subarachnoid hemorrhage（ SAH） with initial negative cerebral angiography and the application of three-dimensional digital subtraction angiography（ 3D-DSA） in the second angiography are discussed. Methods Clinical data of 63 cases of SAH with initial negative angiography were analyzed retrospectively. A total of 62 cases followed the directions to undergo 3D-DSA for the second time. One case died because of rehaemorrhagia in waiting for review. Results Intracranial aneurysms were found in 5 cases,of which 4cases were performed the endovascular treatment and 1 case were followed up because of microaneurysm and follow-up observation. Conclusion Cerebral vasospasm and microaneurysms are the substantial cause for the initial negative cerebral angiography. For patients of SAH with initial negative cerebral angiography a second angiography is necessary. 3D-DSA plays an important role in the second angiography.

关 键 词：蛛网膜下腔出血 颅内动脉瘤 血管痉挛 三维数字减影血管造影 

分 类 号：R743.35[医药卫生—神经病学与精神病学]