蛛网膜下腔出血脑血管造影假阴性原因分析

目的 探讨蛛网膜下腔出血(SAH)脑血管造影假阴性发生的可能原因,提高SAH病因诊断的准确性.方法 回顾性分析452例SAH患者的脑血管造影结果初次阴性52例,复查造影25例,发现6例有异常病变:4例前交通动脉瘤,1例C<,2>段动脉瘤,1例脑血管畸形.结果 结合文献对这6例初次脑血管造影假阴性的原因进行分析,总结发生假阴性的原因.结论 SAH造影时应采用高分辨率的造影机;二维造影时要多角度投射,避开血管间的重叠;必要时采用三维血管重建;提高阅片医生的能力;初次阴性病例可配合CTA、MRA检查且必须强调全面细致复查造影.

False-negative analysis of cerebral angiography in primary subarachnoid hemorrhage

Objective To discuss the false-negative reasons of cerebral angiography in subaraehnoid hemorrhage , which could increase the accuracy of etiological diagnosis and final diagnosis in SAH. Method We retrospectively analyze 452 cases in cerebral angingraphy of primary subaraehnoid hemorrhage patients. 52 negative cases were found and 25 cases were eounterchecked. In 25 cases 6 positive anomalies were found , 4 anterior communicating artery aneurysms and 1 C<,2> portion aneurysms and 1 arteriovenous malformation were detected in the secondary examination of cerebral angiography. Results We analyze and summarize the false-negative reasons in primary cerebral angiography associated with the literature.Conclusions It would be better to adopt high resolving power and three-dimensional technique of digital subtraction machine during angiography. In order to avoid overlapping vessel, enough angles are demanded during angiography. The experience of data-analyzing neuroradioiogist should be improved. The primary negative cases are recommended to do CTA or MRA , they are emphasized doing the fuU-scale secondary examination during angiography.