动脉瘤性蛛网膜下腔出血的影像学特征及早期临床诊断

目的探讨动脉瘤性蛛网膜下腔出血(SAH)的影像学特征及早期病因学诊断方法,并客观评价其优缺点。方法对115例动脉瘤性SAH采用CT、CTA、MRI、MRA、DSA等影像学检查并结合病史、临床表现进行早期临床诊断。结果115例SAH均在急性出血期内(7天)被早期诊断,其中有96例患者在7天内被DSA检查诊断为动脉瘤,早期病因诊断率83.5%,另19例在7天后二次造影诊断。全组9例行MRA,6例发现动脉瘤;12例行CTA,9例发现动脉瘤。结论采用CT及DSA可以对动脉瘤性SAH进行早期病因学诊断;该方法安全、准确,对动脉瘤性SAH的早期诊断、早期治疗具有重要的应用价值。

Radiological features and cl inical diagnosis at early stage of aneurismal subarachnoid hemorrhage

Objective To investigate the imaging features and the methods of early etiological diagnosis of aneurismal subarachnoid hemorrhage (SAH), and to evaluate their advantages and disadvantages objectively. Methods We used the imaging examinations such as CT, computed tomography angiography (CTA), MRI, MRA, combination with the history and clinical manifestations to make the early diagnosis of aneurismal SAH in 115 cases. Results SAH were all early diagnosed in acute bleeding stage (7 days). Among them, 96 cases were diagnosed as aneurysms by DSA examinations in 7 days, the early etiological diagnosis rate was 83.5%; the other 19 cases were diagnosed by secondary DSA after 7 days. In the whole group, there were 9 cases being examined by MRA, 6 patients were diagnosed as aneurysms; 12 cases were examined by CTA, 9 cases were diagnosed as aneurysms. Conclusion Aneurismal subarachnoid hemorrhage can be etiologically diagnosed at early stage of the disease with CT and DSA. The proposed methods are safe and accurate. They are valuable for early diagnosis and treatment of aneurismal subarachnoid hemorrhage.