磁共振在脑出血患者血管畸形诊断中的应用

Diagnosis application of MRI in the vascular malformation with cerebral hemorrhage patients

目的用磁共振方法检测自发性脑血管出血患者是否存在隐匿性血管畸形,以探讨该方法在临床诊断中的作用。方法研究对象为百色市人民医院神经外科收治的亚急性脑出血患者151例,均用磁共振(MRI)/磁共振造影(MRA)和数字减影血管造影(DSA)对亚急性期血管结构进行检查。对其敏感性、特异性以及一致性进行评估。计算MRI/MRA的阳性预测值(PPV)和阴性预测值(NPV)。结果在151例有出血的患者中有70例(46.36%)有血管病变。有血管异常的患者较年轻(33±15)岁,有高血压史患者少(5.88%),病灶更趋向于内血管出血(22.06%)。在脑动脉畸形和硬脑膜动静脉瘘的患者,MRI/MRA的PPV为0.98,NPV为1.00。结论 MRI/MRA可用于亚急性期患者结构性血管畸形的检测,该方法可用于疾病的筛查。

Objective To observe the occult vascular malformation in patients with spontaneous intracerebral hemorrhage. Methods A total of 151 cases with subacute cerebral hemorrhage in the department of neurosurgery were examined for vascular malformation in the subacute phase structure by magnetic resonance imaging(MRI)/magnetic resonan ceangiography(MRA) and digital subtraction angiogra phy(DSA). Their sensitivity, specificity and consistency were evaluated. The positive predictive values(PPV) and the negative predictive value(NPV)of MRI/MRA were calculated. Results In bleeding patients, there were 70 patients(46.36%) with vascular disease. Vascular malformation patients tended to be younger(33±15 years), there was less in patients with a history of hypertension(5.88%), lesions tended to be vascular hemorrhage(22.06%). In cerebral arteries deformity and duralarteriovenous fistula patients, PPV of MRI/MRA was 0.98, NPV was 1.00. Conclusions MRI/MRA can detect most structural vascular malformation in subacute period patients, therefore it should be used in disease screening.