中脑周围非动脉瘤性蛛网膜下腔出血的CT诊断价值

CT Diagnostic Value of Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage

目的分析中脑周围非动脉瘤性蛛网膜下腔出血(PNSH)12例CT及CTA表现,探讨其影像特性。材料和方法回顾分析12例DSA及CTA检查阴性的局限于中脑周围SAH患者临床表现、CT特点。结果出血范围均位于脑干周围的脑池内,12例中9例CTA检查3例DSA检查均无阳性发现。结论 PNSH具有典型的CT表现,CTA的诊断价值甚至高于DSA,既通过平扫了解出血部位,同时又能排除动脉瘤破裂所致,但对于CTA表示怀疑的仍可以进一步行DSA检查,提高诊断准确性。

Objective To explore image characteristics of perimesencephalic nonaneurysmal subarachnoid hemorrhage（PNSH） by analyzing CT and CTA manifestations of 12 cases with PNSH. Methods The clinical manifestations and CT characteristics of 12 cases with SAH confined to the midbrain and DSA and CTA negative patients were retrospectively analyzed. Results The scope of hemorrhage was limited in the cistern around the brain stem. CTA examination of 9 cases and DSA examination of 3 cases were negative. Conclusion PNSH have typical CT manifestations. The diagnostic value of CTA is even higher than DSA. It could show hemorrhage locations by plain-scanning and eliminate aneurysm rupture. But for the CTA suspected cases can still undergo DSA examination to improve the diagnostic accuracy.