脑血管CTA预测高血压脑出血患者血肿扩大的临床分析

Clinical analysis of CT-agiography in the prediction of acute hypertensive intracerebral hematoma expansion

目的分析脑血管CTA检查中造影剂外渗与急性期高血压脑出血血肿扩大的关系。方法 63例急性期高血压脑出血患者入院后行头颅CT及脑血管CTA检查,24 h后复查头颅CT,观察造影剂外渗情况,分析脑血管CTA检查过程中造影剂外渗与血肿扩大的关系。结果血肿扩大组11例(17.46%),血肿无扩大组52例(82.54%)。血肿扩大11例患者中造影剂外渗者9例,CTA阳性预测血肿扩大准确率81.82%,造影剂外渗患者血肿量增加(27.63±11.52)ml,造影剂无外渗患者血肿量增加(3.12±1.48)ml(P=0.006),血肿扩大组血肿量增加(20.18±12.27)ml,血肿无扩大组出血量增加(1.59±1.05)ml(P=0.027)。结论在脑血管CTA检查中,造影剂外渗与急性期高血压脑出血血肿扩大有明显相关性,可预测高血压脑出血血肿扩大情况。

Objective To evaluate the relationship between contrast extravasation of CT - agiography and hematoma expansion in acute hypertensive intraeerebral hemorrhage. Methods Sixty - three patients with acute hypertensive intracerebral hemorrhage were enrolled in this study from January 2010 to January 2011. They underwent acute CT and CTA scan, followed by repeated CT scan after 24 hours to detect contrast extravasation. The relationship between bematoma expansion and contrast extravasation was analyzed. Resuits Among the 63 acute hypertensive intracerebral hemorrhage patients, 11 were found to have hematoma expansion in CT scan,9 of whom were found to have contrast extravasation in CTA scan. The positive rate CTA prediction was 81.82%. Conclusions CTA scan can facilitate the prediction of acute hypertensive intracerebral hemorrhage bematoma expansion, and contrast extravasation is signifi- cantly associated with hematoma expansion.