CAJ | 학술논문

目的：探讨CT联合CTA对动脉瘤性蛛网膜下腔出血（ASAH）的早期诊断价值。方法搜集75例动脉瘤性蛛网膜下腔出血患者，所有病例均有急性期 CT平扫、CTA和DSA检查。对出血分布和出血量与破裂动脉瘤部位、出血与症状性脑血管痉挛（SCVS）以及CTA进行回顾性分析。结果 SAH按改良Fisher分级，Ⅰ级7例（9.33%），Ⅱ级17例（22.67%），Ⅲ级32例（42.67%），Ⅳ级19例（25.33%）。 ASAH的分布与动脉瘤的位置有一定规律，差异有统计学意义（P﹤0.05）。其中19例（25.33%）出现SCVS，不同Fisher分级与SCVS发生率具有统计学差异（P<0.05）。在检出动脉瘤方面，DSA共发现87个，CTA共发现85个，P＞0.05，两种检查方法间无统计学差异。结论 CT对急性ASAH可以间接推测动脉瘤的部位，对初步定位有一定意义，并可对SAH继发的SCVS具有前瞻性提示作用。 CTA与DSA对比具有良好的一致性，CT和CTA联合检查对早期诊断和指导ASAH的治疗、防止和减少并发症有重要的临床意义。
목적：탐토CT연합CTA대동맥류성주망막하강출혈（ASAH）적조기진단개치。방법수집75례동맥류성주망막하강출혈환자，소유병례균유급성기 CT평소、CTA화DSA검사。대출혈분포화출혈량여파렬동맥류부위、출혈여증상성뇌혈관경련（SCVS）이급CTA진행회고성분석。결과 SAH안개량Fisher분급，Ⅰ급7례（9.33%），Ⅱ급17례（22.67%），Ⅲ급32례（42.67%），Ⅳ급19례（25.33%）。 ASAH적분포여동맥류적위치유일정규률，차이유통계학의의（P﹤0.05）。기중19례（25.33%）출현SCVS，불동Fisher분급여SCVS발생솔구유통계학차이（P<0.05）。재검출동맥류방면，DSA공발현87개，CTA공발현85개，P＞0.05，량충검사방법간무통계학차이。결론 CT대급성ASAH가이간접추측동맥류적부위，대초보정위유일정의의，병가대SAH계발적SCVS구유전첨성제시작용。 CTA여DSA대비구유량호적일치성，CT화CTA연합검사대조기진단화지도ASAH적치료、방지화감소병발증유중요적림상의의。
Objective To analyze the early diagnosis potentiality of CT and CTA in the aneurismal subarachnoid hemorrhage (ASAH).Methods 75 cases of aneurismal subarachnoid hemorrhage (SAH)patients underwent CT,computed tomographic angiography (CTA) and digital substraction angiography (DSA).Relationship of bleeding morphological characteristic and aneurysm site was retrospectively analyzed.The releance of symptomatic cerebral vasospasm(SCVS) and blood volume was determined.The dif erence between CTA and DSA were retrospectively analyzed.Results According to Fisher grading standards,class Ⅰ7 cases (9.33%), Ⅱgrade 17 cases (22.67%),Ⅲgrade 32 cases (42.67%), Ⅳgrade 19 cases (25.33%).There were significant dif erences between the bleeding morphological characteristic and aneurysm site (P﹤0.05). SCVS occurred in 19 cases(25.33%),the incidence of SCVS among dif erent Fisher grades were statistical y significantly dif erent(P<0.05).87 aneurysms were found in DSA and 85 aneurysms were found in CTA. There was no significant dif erence between CTA and DSA (P>0.05). Conclusion CT can indirectly speculate the position of aneurysm,help to diagnose the SCVS according Fisher grade prospectively.CTA has good consistency compared with DSA.CT combined CTA play an important role in diagnosing and guiding the treadment of ASAH and preventing complications.