数字减影CT血管成像在蛛网膜下腔出血诊断中的价值

目的探讨数字减影CT血管成像(DSCTA)在蛛网膜下腔出血(SH)诊断中的应用价值。方法分析72例经DSA和(或)手术确诊为动脉瘤的SH患者的CTA资料,比较常规CTA和数字减影CTA的三维容积再现(3DVR)图像重建的图像质量、重建使用时间、检出动脉瘤的大小、敏感性和特异性。结果本组72例88个动脉瘤,DSCTA检出动脉瘤的敏感性和特异性为100%,常规CTA检出动脉瘤的敏感性为89.8%,特异性为100%;DSCTA与常规CTA检出动脉瘤的大小无显著性差异;DSCTA可检出全部床突下与颅骨紧贴的动脉瘤,图像信噪比略下降,但增加了血管对比度,图像重建时间无显著性增加。结论DSCTA同常规CTA相比是一种快速、易行和可靠的CTA技术,使血管对比度明显增加,有利于床突下动脉瘤的检出。DSCTA可作为检出动脉瘤的首选检查方法,避免有创的DSA检查。

Value of digital subtraction CT angiography in subarachnoid hemorrhage

Objective To evaluate the diagnostic value of digital subtraction CT angiography (DSCTA) in subarachnoid hemorrhage (SH). Methods The CT angiographic data of 72 aneurysms patients with SH diagnosed by DSA and/or surgery were analyzed. With DSCTA, the image quality, time of reconstruction, size of aneurysms, sensitivity and specificity in aneurysms detection in 3D volume rendering (3D VR) were compared with conventional CTA. Results Eighty-eight aneurysms were detected in 72 patients by DSCTA, with 100% sensitivity and specificity, while only 89.8% and 100% respectively with conventional CTA. There was no significant difference in the display of aneurysms size and consumption of postprocessing time. All aneurysms near cranial bottom could be successfully detected by DSCTA, with slightly decreased image signal to noise ratio and improved vessel contract. There was no significantly increase in postprocessing time. Conclusion Compare with conventional CTA, DSCTA is a fast, easy and reliable techniques, improved contrast of vessel with slightly reduce in image quality. DSCTA is a primary choice for aneurysm detection in SH, to avoid invasive DSA.