【摘要】 目的探讨CT血管成像(CTA)及数字减影血管造影(DSA)对颅内动脉瘤的临床应用价值。方法收集因动脉瘤引起蛛网膜下腔出血(SAH)的住院患者102例,男52例,女50例。均行CTA及DSA检查;CTA及DSA检查均为阴性的患者,4周后复查CTA。比较CTA与DSA在颅内动脉瘤诊断及辅助治疗方面的差异。结果 102例患者中确诊动脉瘤108个。其中CTA检出动脉瘤107个,2个为假阴性,1个为假阳性;DSA检出动脉瘤107个,1个为假阴性。CTA提示可行介入或外科手术治疗者100个,由于动脉瘤基底过宽或发出大分支而采取保守治疗者7个;DSA提示可行介入或外科手术治疗者100个,保守治疗者7个;两者之间差异无统计学意义。结论 DSA作为颅内动脉瘤传统的诊断方法仍是诊断的"金标准"。CTA作为简便的非损伤性血管检查方法,可作为SAH的首要诊断依据,对术后复查患者更具实用价值,而对于SAH急性期病因诊断更加具有广阔的应用前景。更多还原

【Abstract】 Objective To explore clinical values of computed tomography angiography(CTA) and digital subtraction angiography(DSA) in intracranial aneurysm.Methods There were 102 cases of subarachnoid hemorrhage(SAH) caused by aneurysm in hospitalized patients,in which 52 cases were male,50 cases female.All the patients underwent CTA and DSA examinations.If both CTA and DSA were negative,CTA would be reviewed four weeks later.Comparisons of differences between CTA and DSA were evaluated in diagnosis and prompt treatment of intracranial aneurysm.Results 108 aneurysms were confirmed in 102 patients.107 aneurysms were detected and two were false negative by CTA,in which one was false positive.107 aneurysms were detected by DSA and one was false negative.CTA suggested possible intervention or surgical treatment in 100 aneurysms.In other 7 aneurysms,the conservative therapy was accepted due to great base or too much branch of aneurysms.DSA suggested possible interventional or surgical treatment in 100 aneurysms,conservative treatment in 7 aneurysms.There were no significant difference between the two ways.Conclusion DSA for the diagnosis of intracranial aneurysms as a conventional method remains the gold standard.As a simple non-invasive vascular screening method,CTA can be used as the primary diagnosis mode of SAH and had a more practical value in postoperative patients,even CTA has broad prospects in the etiologic diagnosis of acute SAH.更多还原