64排螺旋CT在自发性蛛网膜下腔出血病因诊断中的价值

目的探讨64排螺旋CT血管造影(CTA)在自发性蛛网膜下腔出血(SAH)病因诊断中的应用价值。方法67例自发性SAH患者进行64排螺旋CTA检查,层厚0.625mm,后处理技术包括多层面重建(MPR)、表面遮盖重建(SSD)、容积显示重建(VR)、最大密度投影重建(MIP),并对照手术及介入栓塞治疗结果评估其诊断价值。结果64排螺旋CTA共发现46例48个动脉瘤,脑动静脉畸形(AVM)14例,海绵状血管瘤2例,静脉窦栓塞1例,阴性4例。64排螺旋CTA能清晰显示动脉瘤的瘤体大小、瘤颈、瘤顶指向、载瘤动脉及动脉瘤与邻近血管和骨性组织的空间关系;能清晰显示AVM供血动脉、异常血管团及引流静脉。结论64排螺旋CTA微创、快捷、可靠性高,可作为自发性SAH病因诊断的首选检查手段。

Application of 64 rows helical CT angiography in diagnosis of the causes of the spontaneous subarachnoid hemorrhage

Objective To evaluate the clinical value of 64 rows helical CT angiography(CTA)in diagnosis of the causes of the spontaneous subarachnoid hemorrhage(SAH).Methods Sixty-seven patients suspected of the spontaneous SAH underwent 64 rows helical CTA,and the slice thickness were 0.625 mm.The data of all patients were reconstructed with multi plane reconstruction(MPR),shade surface display(SSD),volume rendering(VR),maximum intensity projection(MIP).The volume were evaluated with the results of surgery or digital subtraction angiography(DSA).Results A total of 48 aneurysms in 46 cases,14 cases of AVM,2 cases of cavernous angiomas,and 1 case of venous sinus thrombosis were detected by 64 rows helical CTA.Four cases were negative.64 rows helical CTA could demonstrate the size,shape,neck,axis point of the aneurysms,the three dimensional relationship of aneurysms to parent vessels,other branches and bone structure more clearly.It demonstrated the feeding arteries,malformated vessel masses and draining veins of AVM more clearly too.Conclusion 64 rows helical CTA is a woundless,quick,high accuracy method for detecting the spontaneous SAH,and it can be used as the first choice for screening spontaneous SAH.