DSA和MRA检测在亚急性自发性脑出血诊断中应用的价值比较

目的：探讨核磁共振血管造影(MRA)和数字减影血管造影(DSA)技术诊断亚急性期自发性脑出血患者脑血管结构异常的临床价值,为脑血管结构异常的检查提供临床依据。方法：选择亚急性自发性脑出血发病1周内的患者183例，使用DSA和MRA法检测亚急性自发性脑出血患者的基本结构血管异常。结果：MRA和DSA检测，顶叶、额叶和豆状核3个部位自发性脑出血的几率最大，分别占全部出血部位的17.5%、16.9%和14.2%；存在脑血管结构异常患者的年龄、高血压的发生率小于不存在脑血管结构异常患者（P＜0.05），亚急性自发性脑出血与患者年龄、高血压发生率呈正相关关系（r=0.43,r=0.46，P＜0.05）；MRA和DSA检测脑血管畸形率差异无统计学意义；以DSA为诊断金标准，MRA检测脑血管畸形灵敏度特异度分别为98.8%和96.9%。 结论： MRA与DSA均可应用于诊断亚急性自发性脑出血患者的血管结构异常，MRA有无创性的优势，更值得临床推广。
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Comparison of application value of DSA and MRA in diagnosis of subacute spontaneous intracerebral hemorrhage

Objective To explore the clinical value of digital subtraction angiography(DSA) and magnetic resonance angiography(MRA) in diagnosis of cerebral vascular structural abnormalities in the patients with spontaneous cerebral hemorrhage in subacute phase,and to provide clinical basis for detection of cerebral vascular structural abnormalities.Methods 183 patients with subacute spontaneous intracerebral hemorrhage within 1 week were selected,the vascular structures of the patients were detected by DSA and MRA,and the influence factors were analyzed.Results The DSA and MRA results showed that the parietal lobe,frontal lobe,and lenticular nucleus had the largest incidence rates of spontaneous intracerebral hemorrhage,and accounted for 17.5%,16.9%,and 14.2%,respectively.The age and the incidence of the hypertension of the patients with cerebral vascular structural abnormalities were significantly lower than those of the patients without cerebral vascular structural abnormalities(P<0.05).There were positive correlations between subacute spontaneous cerebral hemorrhage and the age and the incidence of hypertension(r=0.43,r=0.46,P<0.05).The rates of cerebrovascular malformation detected with MRA and DSA had no statistically significant difference.The DSA was regarded as detection gold standard,the sensitivites and specificities of MRA in detection of cerebrovascular malformation were 98.8% and 96.9%.Conclusion The abnormal vascular structures of patients with subacute spontaneous intracerebral hemorrhage can be detected mostly by MRA and DSA.MRA has the advantages of non-invasion,which is worthy to be applied in clinic.