容积CT数字减影血管造影对脑血管创伤的应用价值

Volume Computed Tomographic Digital Subtraction Angiography in Diagnosing Post-traumatic Cerebral Vascular Changes

目的探讨容积CT数字减影血管造影(VCTDSA)诊断及随访脑血管创伤后改变的价值。资料与方法回顾性分析104例颅脑创伤患者共124个VCTDSA检查资料,观察创伤性脑血管损伤(TCVI)及脑血管继发性改变的VCTDSA表现。结果本组病例中脑血管表现正常68例,创伤性脑血管损伤21例,包括创伤性颈内动脉海绵窦瘘15例,创伤性动脉瘤4例,静脉窦损伤4例(其中2例为复合伤);创伤后继发性脑血管改变16例,包括动脉血栓形成1例,创伤性脑血管痉挛5例(其中1例合并创伤性动脉瘤),脑血管推移9例,静脉扩张1例。结论 VCTDSA可准确显示创伤性脑血管改变,在诊断及随访创伤性脑血管改变中具有重要临床价值。

Purpose To evaluate volume computed tomographic digital subtraction angiography （VCTDSA） in diagnosing and following up post-traumatic cerebral vascular changes. Materials and Methods 124 VCTDSA examinations in 104 patients with previous head trauma were retrospective analyzed. The features of traumatic cerebral vascular injury （TCVI） and secondary changes of post-traumatic cerebral vascular were observed with VCTDSA. Results In this study, there were 68 patients of normal appearances, 21 patients with TCVIs, including 15 traumatic carotid cavernous fistulas, 4 traumatic intracranial aneurysms, and 4 cranial venous sinus injuries. There were 16 patients with secondary changes of post-traumatic cerebral vascular, including I arterial thrombosis, 5 traumatic cerebral vasospasm （1 associated with traumatic intracranial aneurysm）, 9 cerebrovascular displaced, 1 vein expansion. Conclusion VCTDSA of variety post-processing techniques, multi-dimensional accurately displays post-traumatic cerebral vascular changes, has important clinical value in diagnosing and following up of these diseases.