CT和CTA联合检查在动脉瘤性蛛网膜下腔出血早期临床价值.docVIP

CT和CTA联合检查在动脉瘤性蛛网膜下腔出血早期临床价值 　　摘要：目的 探讨CT联合CTA对动脉瘤性蛛网膜下腔出血（ASAH）的早期诊断价值。方法 搜集75例动脉瘤性蛛网膜下腔出血患者，所有病例均有急性期CT平扫、CTA和DSA检查。对出血分布和出血量与破裂动脉瘤部位、出血与症状性脑血管痉挛（SCVS）以及CTA进行回顾性分析。结果 SAH按改良Fisher分级，Ⅰ级7例（9.33%），Ⅱ级17例（22.67%），Ⅲ级32例（42.67%），Ⅳ级19例（25.33%）。ASAH的分布与动脉瘤的位置有一定规律，差异有统计学意义（P?0.05）。其中19例（25.33%）出现SCVS，不同Fisher分级与SCVS发生率具有统计学差异（P0.05）。在检出动脉瘤方面，DSA共发现87个，CTA共发现85个，P＞0.05，两种检查方法间无统计学差异。结论 CT对急性ASAH可以间接推测动脉瘤的部位，对初步定位有一定意义，并可对SAH继发的SCVS具有前瞻性提示作用。CTA与DSA对比具有良好的一致性，CT和CTA联合检查对早期诊断和指导ASAH的治疗、防止和减少并发症有重要的临床意义。 　　关键词：体层摄影术；螺旋计算机；动脉瘤；蛛网膜下腔出血 　　The Early Clinical Value of CombinedCT and CTA in Aneurysmal Subarachnoid Hemorrhage 　　FU Shun-bin1,YANG Hai-li1,GOU Zhen-heng1,REN A-hong1,LI Li1,SONG Ying2 　　(1.Department of Adiology ,Peoples Hospital of Beijing Daxing District,Beijing 102600,China;2.Department of Neurosurgery,Peoples Hospital of Beijing Daxing District,Beijing 102600,China) 　　Abstract：Objective To analyze the early diagnosis potentiality of CT and CTA in the aneurismal subarachnoid hemorrhage（ASAH）.Methods 75 cases of aneurismal subarachnoid hemorrhage（SAH）patients underwent CT,computed tomographic angiography(CTA) and digital substraction angiography(DSA).Relationship of bleeding morphological characteristic and aneurysm site was retrospectively analyzed.The releance of symptomatic cerebral vasospasm(SCVS) and blood volume was determined.The difference between CTA and DSA were retrospectively analyzed.ResultsAccording to Fisher grading standards,class Ⅰ 7 cases(9.33%),Ⅱ grade 17 cases(22.67%),Ⅲ grade 32 cases(42.67%),Ⅳ grade 19 cases(25.33%).There were significant differences between the bleeding morphological characteristic and aneurysm site（P?0.05）. SCVS occurred in 19 cases(25.33%),the incidence of SCVS among different Fisher grades were statistically significantly different(P0.05).87 aneurysms were found in DSA and 85 aneurysms were found in CTA. There was no significant difference between CTA and DSA（P＞0.05）. ConclusionCT can indirectly speculate the position of