头颈部CT血管造影对自发性脑出血病因学诊断的应用价值  

The value of CT angiography in the etiological diagnosis of spontaneous cerebral hemorrhage

作　　者：朱晓红[1] 钟亚鼎[1] 李小虎[1] 王晓敏[1] 刘斌[1] 余永强[1] ZHU Xiaohong;ZHONG Yading;LI Xiaohu;WANG Xiaomin;LIU Bin;YU Yongqaing(Department of CT Room,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院CT室,安徽合肥230022

出　　处：《安徽医药》2020年第11期2203-2206,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨头颈部CT血管造影(CTA)血管成像对于自发性脑出血(ICH)病因学诊断的应用价值。方法回顾性分析2016年1月至2018年12月安徽医科大学第一附属医院200例ICH病人的头颈CTA资料及相关临床资料。分析ICH病人不同病因学发病年龄之间的差异,比较CTA与数字减影血管造影(DSA)诊断的符合度及CTA血肿内造影剂外渗所致斑点征对于预测脑出血血肿扩大的意义,从而评价头颈CTA在ICH病人中的应用价值。结果200例ICH病人中由动脉瘤、动静脉畸形、烟雾病等血管性疾病所致的脑出血共计65例,高血压性脑出血106例,不明原因所致脑出血29例,其中高血压性脑出血病人所占比例(53.0%),明显高于由其他血管性疾病所致ICH。CTA与DSA比较诊断效率达94.3%。头颈CTA斑点征对于预测ICH病人后续血肿扩大差异有统计学意义(F=13.2,P<0.001),其作为血肿扩大的预测因素阳性预测值达80%,阴性预测值达92.9%。结论头颈部CTA可以作为ICH病人常规检查方法指导临床治疗。Objective To investigate the significance of CTA angiography in the etiological diagnosis of spontaneous cerebral hemorrhage.Methods Two hundred patients with spontaneous intracranial hemorrhage were enrolled in the First Affiliated Hospital of Anhui Medical University from January 2016 to December 2018.Their demographic and imaging data were analyzed.The difference between the ages of different etiology of ICH patients were analyzed.The diagnostic consistency of CTA with DSA was compared.And to explore the significance of spot sign caused by contrast agent extravasation in CTA angiography for predicting the expansion of cerebral hemorrhage.Results Of the 200 patients with ICH,65 suffered from cerebral hemorrhage caused by vascular diseases such as aneurysm,arteriovenous malformation and moyamoya disease,106 cases of hypertensive intracerebral hemorrhage,and 29 cases of cerebral hemorrhage caused by unknown causes.The proportion of ICH patients with hypertension was 53.0%,which was significantly higher than that caused by other vascular diseases.The rate of lesions detected by CTA compared with DSA was 94.3%.Spot sign was significantly different for predicting subsequent hematoma enlargement in ICH patients(F=13.2,P<0.001),and its positive predictive value for hematoma enlargement was 80%,and negative predictive value was 92.9%.Conclusion Head and neck CTA can be used as a routine examination method for ICH patients to guide clinical treatment.

关 键 词：脑出血 血管造影术 数字减影 脑底异常血管网病 颅内动静脉畸形 颅内出血 高血压性 

分 类 号：R743.34[医药卫生—神经病学与精神病学]