320排CT对DSA造影阴性自发性蛛网膜下腔出血患者后期随访的价值

The Potential Application Value of 320-Slice Computed Tomography Angiography for Digital Subtraction Angiography Negative Spontaneous Subarachnoid Hemorrhage

目的探讨320排CT在普通CT血管造影(CTA)检查及全脑数字减影血管造影(DSA)检查阴性的自发性蛛网膜下腔出血(SAH)患者后期随访中的临床价值。方法回顾性分析2012年2月至2015年12月首次DSA检查阴性的SAH患者35例的临床资料,并在后期采用320排CT进行定期随访。结果随访0.5~4年,35例患者首次DSA检查阴性后第1次320排CT随访发现微小动脉瘤3例,发现动、静脉畸形1例;第2次随访发现动脉瘤1例,烟雾病1例,动、静脉畸形1例。第3次随访发现动脉瘤1例。随访期间有2例因再次发生蛛网膜下腔出血入院诊断为动脉瘤破裂。结论在DSA检查阴性的SAH患者需要后期跟踪随访,320排CT检查因其无创性及依从性好且对脑血管疾病具有很高的诊断价值,可作为该病患者的首选随访检查。

Objective To explore the clinical value of 320-slice CT in the follow-up of patients with spontaneous subarachnoid hemorrhage(SAH) who had a negative examination on CTA and digital subtraction angiography(DSA). Methods The clinical data of 35 patients with spontaneous subarachnoid hemorrhage who had a negative examination on DSA(from February 2012 to December 2015) was retrospectively analyzed, and 320-slice CT was used for regular follow-up. Results All patients were followed up with 320-slice CT for 0.5-4 years. Three microaneurysms and one arteriovenous malformation were found on the first 320-slice CT examination. One intracranial aneurysm, one moyamoya disease, and one arteriovenous malformation were found on the second 320-slice CT examination. The third 320-slice CT examination diagnosed one intracranial aneurysm. Two patients were admitted to hospital due to recurrent subarachnoid hemorrhage and diagnosed as ruptured aneurysm during the follow-up. Conclusion Patients with spontaneous subarachnoid hemorrhage with negative DSA test require follow-up follow-up. 320-slice CT scan is the first choice for such patients because of its non-invasiveness, good compliance, and high diagnostic value for cerebrovascular diseases. Follow-up inspection.