四组影像技术在疑脑动脉瘤破裂出血诊疗价值比较

Comparison of Diagnostic Value of Four Groups of Imaging Techniques in the Diagnosis and Treatment of Ruptured Cerebral Aneurysm

目的:探讨CT平扫+3D-MRA+3D-DSA技术在疑脑动脉瘤破裂出血诊疗价值。材料与方法:筛选临床上疑脑动脉瘤破裂出血28例患者,先行CT例平扫,发现蛛网膜下腔,再行3D-MRA诊断为脑动脉瘤破裂者,后行DSA全脑血管造影术,并应用3D成像技术进行三维重建,发现26例自发性蛛网膜下腔出血,13例为脑动脉瘤破裂出血,1例为脑动静脉畸形,11例为高血压动脉硬化性破裂出血,2例为正常。术中对动脉瘤者行可脱式弹簧圈进行栓塞术。结合相关文献,并与3D-CTA+3D-DSA、3D-MRA+3D-DSA与3D-DSA诊疗方法比较,分析4种诊疗方法受检者受辐射剂量,准确性,完成时间及费用。结果:平均每位患者受辐射剂量比较如下:3D-DSA=3DMRA+3D-DSA<CT平扫+3D-MRA+3D-DSA<3D-CTA+3D-DSA;准确性比较如下:CT平扫+3D-MRA+3D-DSA>3D-CTA+3D-DSA>3D-MRA+3D-DSA>3D-DSA;完成时间比较如下:3D-DSA<CT平扫+3D-MRA+3D-DSA<3D-CTA+3D-DSA<3D-MRA+3D-DSA;费用比较如下:3D-DSA<CT平扫+3D-MRA+3D-DSA<3D-CTA+3DDSA<3D-MRA+3D-DSA。结论:综合评价,CT平扫+3D-MRA+3D-DSA在疑脑动脉瘤破裂出血诊疗价值相对较高,值得推广应用。

Purpose： To investigate the value of CT scan in the diagnosis and treatment of ruptured cerebral aneurysm with ＋ 3D-MRA ＋ 3D-DSA scan. Materials and Methods： for screening clinical suspected cerebral aneurysm rupture and hemorrhage in 28 patients, CT of go ahead of the rest cases were performed plain CT scan, found subarachnoid and 3D-MRA diagnosis for cerebral aneurysm rupture and underwent DSA cerebral angiography, and application of 3D imaging technique for 3D reconstruction, 26 cases of spontaneous subarachnoid hemorrhage, 13 cases of cerebral aneurysm rupture and bleeding, 1 case of cerebral dynamic venous malformation, 11 cases of hypertensive arteriosclerosis of rupture and hemorrhage, 2 cases as normal. Detachable coil for embolization of aneurysm during operation. Combined with the relevant literature, and compared with 3D-CTA ＋3D-DSA, 3D-MRA ＋3D-DSA and 3D-DSA diagnosis and treatment methods, analysis of the 4 methods of di- agnosis and treatment by the radiation dose, accuracy, completion time and cost. The average for each patient by radiation dose is as follows： 3D-DSA = 3D-MRA ＋3D-DSA 〈 CT plain scan ＋3D-MRA ＋3D-DSA 〈 3D-CTA ＋3D-DSA; accuracy is as follows： CT plain scan ＋3D-MRA ＋3D-DSA 〉 3D-CTA＋3D-DSA 〉 3D-MRA＋3D-DSA 〉 3D-DSA; completion time comparison are as follows： 3D-DSA 〈 CT plain scan ＋3D-MRA ＋3D-DSA 〈 3D-CTA ＋3D-DSA 〈 3D-MRA ＋3D- DSA; cost comparison as follows： 3D-DSA 〈 CT plain scan ＋3D-MRA ＋3D-DSA 〈 3D-CTA ＋3D-DSA 〈 3D-MRA ＋3D- DSA. Conclusion： comprehensive evaluation, CT plain scan ＋ 3D-DSA ＋ 3D-MRA in suspected cerebral aneurysm rupture hemorrhage diagnosis and treatment value is relatively high, it is worth popularizing.