CTA、DSA在出血性脑血管病诊治中的对比研究

目的探讨CT血管造影（CTA）和数字减影血管造影（DSA）诊治出血性脑血管病的价值。方法对65例出血性脑血管病行CTA检查,采用最大强度投影（MIP）和容积成像显示（VR）技术进行三维重建;分析脑血管显示情况并将结果与DSA和（或）手术结果比较。部分动脉瘤病例术后行CTA和DSA复查。结果 CTA对出血性脑血管病的敏感性为83.1%,特异性为100%。能明确动脉瘤的部位、大小、瘤颈及瘤体与载瘤动脉的空间关系;能可靠地显示动静脉畸形的位置、形态、供血动脉和引流静脉。CTA不能很好地反应动脉瘤夹闭情况。结论 CTA是有效的血管成像技术,对出血性脑血管疾病有重要的诊治价值,临床疑诊为出血性脑血管病患者可作为一种筛选方法。CTA不适合动脉瘤术后的复查。

Comparative study of DSA and CTA in diagnosis and treatment of hemorrhagic cerebral vascular diseases

Objective To evaluate the role of CT angiography （CTA） and digital subtraction angiography （DSA） in diagnosis and treatment of hemorrhagic cerebral vascular diseases.Methods A total of 65 patients of hemorrhagic cerebral vascular diseases were examined with CTA.Maximal intensity projection （MIP） and volume rendering （VR） were applied in 3D reconstruction.All the results were compared with DSA and/or operation findings.Some patients with aneurysms underwent postoperative CTA and DSA examination.Results The sensitivity and specificity of CTA in the detection of vascular abnormality in hemorrhagic cerebral vascular diseases were 83.1% and 100%,respectively.CTA could demonstrate clearly the size and location of aneurysm,and the relationship between aneurysm neck,body and parent artery.It could also show definitively the location,morphology,the main supplying arteries,and most of draining veins of AVMs.But CTA could not clearly display the clipping results of aneurysm.Conclusion CTA is an effective angiography which plays an important role in the diagnosis and treatment of hemorrhagic cerebral vascular diseases.It may be used for the screening of patients with hemorrhagic cerebral vascular diseases in clinical practices,while it is not suitable for the post-operation examination of aneurysms.