DSA全脑血管造影的临床应用价值

To investigate the clinical application value on DSA aortocranial angiography

目的探讨DSA全脑血管造影对脑血管疾病的诊断价值。方法选择有造影指征的脑血管疾病(出血性/缺血性)患者164例,行DSA全脑血管造影,分析造影结果,并对治疗情况进行随访。结果诊断情况,缺血性疾病99例:造影发现异常44例,阳性率44.44%(44/99);出血性疾病65例:①50例自发性蛛网膜出血:发现异常36例,阳性率72.00%(36/50)。②15例自发性脑出血(含脑室出血):发现异常10例;阳性率为66.67%(10/15)。总阳性率54.88%(44+36+10/164)。治疗情况,缺血性:颈动脉狭窄:颈动脉支架10例,1例行颈内动脉内膜剥脱术,余予内科保守治疗;颅内动脉狭窄:1例支架植入,余保守治疗;2例烟雾病行颞肌贴覆术。出血性动脉瘤(AN):行介入栓塞20例,手术夹闭5例(外院),其他病例放弃进一步治疗;动静脉畸形(AVM)2例手术(外院),2例γ-刀治疗(外院);硬脑膜动静脉瘘(DAVF)放弃进一步治疗;颈内动脉海绵窦瘘(CCF)介入栓塞;海绵状血管畸形(CA)行手术治疗;烟雾病全部行颞肌贴覆术。结论脑血管造影是脑血管疾病病因诊断的黄金标准,并为进一步治疗提供依据。

Objective To Investigate the clinical diagnostic value on DSA aortocranial angiography in cerebrovascular disease. Methods 164 cerebrovascular disease patients （hemorrhagic/ischemic） with aortocranial angiography indicatio were put into aortocranial angiography; analyzed the opacification consequence, and follow-up visited on the treatment condition. Results About diagnose, in 99 ischemic disease patients,abnormal in 44cases,masculine rate was 44.44% （44/99）;in 65 hemorrhagic diseasepatients,①50 SAH patients：abnormal in 36 cases, masculine rate was72.00% （36/50）.②@15 spontaneouscerebral hemorrhage（including cerebroventricular haemorrhage） patients,abnormal in 10 cases,masculine rate was 66.67%（ 10/15）; the total masculine rate was 54.88% （44＋36＋10/164）. About treatment in ischemic disease, in internal carotid artery narrow patients,10 were act on stent implantation , 1 patient was act on endarterectomy of the internal carotidartery, and others were act on expectant treatment;in intracalvarium arterial stenosis patients, lpatients was act on stent implantation,otherd were act on expectant treatment; 2 Moyamoya disease patients were treated bytemporal musclesticking and covering therapy.About treatment in hemorrhagic disease,20 patients were act on interventional embolic therapy with AN,5 patients were act on occlusion operation（base-court）,others gave up further treatment;in AVMpatients,2 were put into operation （base-court）, 2 were act on γ-knife therapy （hase-court）,DAVF patient gave up further treatment,ccf patient were treated by interventional embolic therapy ; CA patient were treated by operation;Moyamoya disease patients were treated bytemporal muscle sticking and covering therapy. Conclusion DSA aortocranial angiography is the golden dignose standard for cerebrovascular disease,and can put forward more evidence for treatment.