16排螺旋CT血管造影在自发性蛛网膜下腔出血诊断中的应用

Application of 16-slice Spiral CT Angiography in the Spontaneous Subarachnoid Hemorrhage

【目的】探讨16排螺旋CT血管造影(MSCTA)在自发性蛛网膜下腔出血(SAH)患者病因诊断中的应用价值。【方法】回顾性分析38例临床急性原发性SAH患者的临床资料,均分别进行MSCTA和数字减影血管造影(DSA),所有患者均完成VR、MIP、SSD处理,并对照手术或介入结果评估其诊断价值。【结果】MSCTA发现7例动静脉畸形,23例共24个动脉瘤,其中21例为单个动脉瘤,1例为两个动脉瘤,1例合并有动静脉畸形。动脉瘤直径最小2.0 mm,最大20 mm。MSCTA能清晰显示动脉瘤的瘤体大小、瘤颈、瘤轴指向、载瘤动脉及其动脉瘤与邻近血管分支和骨性组织间的空间关系。DSA检查发现25个动脉瘤,MSCTA的吻合率为96%。【结论】MSCTA诊断颅内动脉瘤有较高准确性,可以帮助原发性SAH患者查找病因,指导临床诊断与治疗。

[Objective] To evaluate the value of 16-slice computed tomography angiography （MSCTA） in finding the etiology of spontaneous subarachnoid hemorrhage （SAH）. [Methods] Thirty eight patients with acute spontaneous SAH undergoing CTA were reviewed. All patients received 16-MS CTA and digital subtraction angiography （DSA） simultaneously. The data were reconstructed by using volume rendering（VR）,maximum intensity projection （MIP） and surface shadow display（SSD）. The quality of the reconstructions was compared with digital subtraction angiography（DSA）and surgical findings. [Results] Among 38 patients, 7 were arteriovenous malformation, 23 were cerebral aneurysm. Among 23 patients, 21 had solitary aneurysm, one had two aneurysms and one had an aneurysm and an arteriovenous malformation together. The diameters of the aneurysms were from 2.0mm to 20mm. The body of aneurysms （including morphology, outline and the develop orientation） was demonstrated on MSCTA, and the characteristics of the aneurysm including neck size, width, the relationship to surrounding vessels and its space relationship with the skull were also well dis- played. There were 25 aneurysms identified by DSA. Accuracy rate of CTA in diagnosing aneurysm was 96 （24/25）. [Conclusion]16-MSCTA is a high accurate method in diagnosing intracranial aneurysm and helpful to find the etiology for SAH ,and provides the information for clinical treatment.