三维CT血管造影对动脉瘤性蛛网膜下腔出血诊断的可靠性研究

目的评价三维CT血管造影（3D-CTA）在动脉瘤性蛛网膜下腔出血（aneurysmal subarachnoid hemorrhage,aSAH）诊断的可靠性。方法对我科2010年12月-2011年11月间192名急性蛛网膜下腔出血患者行CT血管造影检查（CTA）检查并应用3D Slicer软件进行三维重建,与数字减影血管造影（digital subtraction angiography,DSA）或术中实际情况进行对比,评价CTA在动脉瘤性蛛网膜下腔出血诊断中的可靠性。结果 192例中,CTA检查出动脉瘤162例,脑血管畸形12例;另有假阴性1例,假阳性1例,均通过DSA及手术证实,3D-CTA在aSAH诊断的灵敏性为96.17%,特异性为94.11%。结论3D-CTA是动脉瘤性蛛网膜下腔出血的首选检查方法。

Reliability of 3D CT angiography in diagnosis of aneurysmal subarachnoid hemorrhage

Objective To evaluate the reliability of 3D-CT angiography（3D-CTA） in diagnosis of aneurysmal subarachnoid hemorrhage（SAH）.Methods One hundred and ninety-two patients with acute SAH who underwent CTA in our department from December 2010 to November 2012 were included in this study.Their 3D-CTA images were reconstructed with 3D Slicer software and compared with digital subtraction angiography（DSA） images or intraoperative actual situation.The reliability of CTA was assessed in diagnosis of aneurysmal SAH.Results 3D-CTA showed aneurysm in 162 patients,cerebral vascular malformation in 12 patients,false negative aneurysm in 1 patient,and false-positive aneurysm in 1 patient,which were confirmed by DSA or surgery,with a sensitivity of 96.17% and a specificity of 94.11%.Conclusion 3D-CTA is the first choice of method in diagnosis of aneurysmal SAH.