CT对动脉瘤性蛛网膜下腔出血早期诊断潜能的探讨

目的 探讨CT对动脉瘤性蛛网膜下腔出血（SAH）的早期诊断潜能.方法 回顾性分析108例动脉瘤性SAH患者在CT上的出血形态特点与动脉瘤部位的关系;按改良Fisher分级评价出血量,判定症状性脑血管痉挛（SCVS）的发生与出血量的相关性.结果 动脉瘤性SAH的CT表现为侧裂、纵裂、脑池铸型高密度影,或伴有额叶直回、侧裂周围的血肿.Fisher分级：Ⅰ级8例,Ⅱ级35例,Ⅲ级44例,Ⅳ级21例.治疗过程中出现SCVS 39例（36.1%）,不同Fisher分级间SCVS发生率比较,差异有统计学意义（P＜0.05）.结论 CT可显示动脉瘤破裂的一些特征性表现,可以间接推测动脉瘤的部位,并能准确对动脉瘤性SAH行Fisher分级,对SAH所致SCVS行前瞻性诊断,对指导动脉瘤性SAH的进一步治疗、防治并发症有重要的临床意义.

Early Diagnostic Potency of CT on Aneurismal Subarachnoid Hemorrhage

Objective To explore the early diagnostic potency of CT on aneurisma] subarachnoid hemorrhage （SAH）. Methods Relationship of bleeding morphological characteristics and aneurysm site in 108 patients with aneurismal SAH was ret- rospective analysis by CT; According to improved Fisher＇s scale, the relevance of symptomatic cerebral vasospasm （SCVS） and blood volume was determined. Results The CT imaging of aneurisma] SAH showed a side of the crack, longitudinal, cistern mold high density, or accompanied by frontal straight back around sylvian hematoma. Fisher grade ： I grade 8 cases, ]] grade 35 cases, ]]I grade 44 cases, IV grade 21 cases. SCVS occured in 39 cases （36. 1% ） , the incidence of SCVS among different Fisher grades were statistically significantly different （ P 〈 0. 05 ）. Conclusion CT can show some of aneurysm rupture characteristic performance, which can indirectly speculate the position of aneurysm, help to analyses the blood volume accurately and diagnose the SCVS according Fisher grade prospectively. A prospective diagnosis of SCVS due to SAH is with great clinical significance in guiding the treatment of aneurismal SAH and preventing complications.