16层螺旋CT血管成像对蛛网膜下腔出血病因的诊断价值

Diagnostic value of 16-slice spiral CT angiography for pathogenesis of subarachnoid hemorrhage

目的探讨分析16层螺旋CT血管成像对蛛网膜下腔出血(SAH)病因的诊断价值。方法 58例蛛网膜下腔出血患者,均先行16层螺旋CT平扫,再行CT血管成像(CTA),之后应用多平面重建、容积再现、最大密度投影等技术,对图像进行处理,观察患者的脑血管情况并对SAH病因进行分析。结果经3D-CTA共发现46例患者有56个动脉瘤、动静脉畸形8例、烟雾病3例、阴性1例;与数字减影血管造影(DSA)或外科手术作为参照,提示3D-CTA诊断颅内动脉瘤的敏感性与特异性分别为97.83%与100.00%。结论 16层螺旋CT血管成像在蛛网膜下腔出血的病因诊断中具有较高应用价值,可作为诊断蛛网膜下腔出血病因的首选方法。

Objective To investigate and analyze the diagnostic value of 16-slice spiral CT angiography for pathogenesis of subarachnoid hemorrhage（SAH）. Methods A total of 58 patients with SAH received plain scan by 16-slice spiral CT, and then received CT angiography（CTA）. Images were processed by multiplanar reconstruction, volume rendering, and maximum intensity projection. Condition of patients＇ cerebral blood vessel was observed to analysis pathogenesis of SAH. Results After 3D-CTA for the 46 cases, there were 56 cases with arterial aneurysm, 8 cases with arteriovenous malformation, 3 cases with moyamoya disease, and 1 negative case. Comparisons with digital subtraction angiography（DSA） or surgical operation showed the sensibility and specificity of 3D-CTA in diagnosing arterial aneurysm were respectively 97.83% and 100.00%. Conclusion 16-slice spiral CT angiography provides high application value in diagnosis of the pathogenesis of SAH, and it can be taken as the preferred method in diagnosing the pathogenesis of SAH.