CTA在出血性脑动静脉畸形救治中的应用价值

目的探讨三维计算机断层摄影血管造影(3D-CTA)在出血性脑动静脉畸形诊断及术前评估中的应用价值。 方法选择自2007年3月至2011年2月收治的破裂脑动静脉畸形患者19例，对所有患者均行头颅CTA检查，并经DSA对照检查、手术证实。 结果首次CTA检查发现14例阳性，其中急诊直接行开颅血肿清除+畸形血管团切除4例，术后复查CTA及DSA提示全切除；3例首次CTA及DSA检查均为阴性,1年后CTA复查发现异常血管团，经DSA检查证实后手术治疗;2例首次及2周后CTA检查阴性，但DSA检查示小型畸形血管团。 结论CTA因其快捷有效、无创伤、安全等优点，尤其适合于出血性脑动静脉畸形的急诊检查，能充分显示脑动静脉畸形三维结构的特点可为手术入路提供良好的依据。

Three-dimensional computed tomographic angiography in hemorrhagic cerebral arteriovenous malformation

Objective To assess the value of three-dimensional computed tomographic angiography (3D-CTA) in hemorrhagic cerebral arteriovenous malformation (AVM). Methods Nineteen patients with hemorrhagic cerebral AVM, admitted to our hospital from March 2007 to February 2011 and conformed by digital subtraction angiography (DSA) and operation, were examined by 3D-CTA. Results In these19 patients, 14 were noted as having AVM in the first examination of which 4 were performed surgical operation (hematoma evacuation and removal of abnormal vessels) directly by the lead of CTA images; the postoperative CTA images and DSA showed that the cerebral AVMs in these 4 patients were removed completely. Three patients, having negative results in the 1st 3D-CTA and DSA examinations, showed abnormal blood vessel mass by CTA re-check after 1 year; they were confirmed by DSA and operation. Two patients, having negative results in the 1st and 2nd Week's 3D-CTA examination,were noted as having small AVMS in DSA. Conclusion The 3D-CTA, being a non-injured, rapid,safe and effective way, can provide details and spacial relation image of the AVM which can assist the surgeon to possible intraoperative design; therefore, it fits for emergency examination of hemorrhagic