CAJ | 학술논문

目的：探讨64层螺旋CT分别减影脑动脉、混合脑动静脉、脑静脉血管成像在自发性颅内出血术前评估价值。方法回顾分析同时行CT血管造影（CTA）和数字减影血管造影（DSA）检查的自发性颅内出血患者共215例。 CTA检查全部行64层螺旋CT平扫、增强动脉早期和静脉早期扫描，将动、静脉早期数据减去平扫数据分别重建动脉及混合动静脉，静脉早期数据减去动脉早期数据重建静脉。结果减影脑动脉、脑静脉血管图像去除了颅骨并且动脉、静脉无相互干扰，分别清晰显示动脉或静脉病变，混合脑动静脉则去除颅骨干扰且同时显示脑动静脉病变。215例颅内出血患者中14例CTA和DSA检查颅内均未见畸形血管，2例动脉瘤DSA发现而CTA未显示，3例动脉瘤CTA发现而DSA未显示。 CTA和DSA共同显示畸形血管196例，敏感性为99．9％，特异性为82．4％，其中动脉瘤179例，动静脉畸形9例，静脉瘤3例，烟雾病5例。结论64层螺旋CT分别减影脑动脉、混合脑动静脉、脑静脉血管成像在颅内出血检查，病变及周围结构显示清楚，对临床术前评估有较大意义，值得推广应用。
목적：탐토64층라선CT분별감영뇌동맥、혼합뇌동정맥、뇌정맥혈관성상재자발성로내출혈술전평고개치。방법회고분석동시행CT혈관조영（CTA）화수자감영혈관조영（DSA）검사적자발성로내출혈환자공215례。 CTA검사전부행64층라선CT평소、증강동맥조기화정맥조기소묘，장동、정맥조기수거감거평소수거분별중건동맥급혼합동정맥，정맥조기수거감거동맥조기수거중건정맥。결과감영뇌동맥、뇌정맥혈관도상거제료로골병차동맥、정맥무상호간우，분별청석현시동맥혹정맥병변，혼합뇌동정맥칙거제로골간우차동시현시뇌동정맥병변。215례로내출혈환자중14례CTA화DSA검사로내균미견기형혈관，2례동맥류DSA발현이CTA미현시，3례동맥류CTA발현이DSA미현시。 CTA화DSA공동현시기형혈관196례，민감성위99．9％，특이성위82．4％，기중동맥류179례，동정맥기형9례，정맥류3례，연무병5례。결론64층라선CT분별감영뇌동맥、혼합뇌동정맥、뇌정맥혈관성상재로내출혈검사，병변급주위결구현시청초，대림상술전평고유교대의의，치득추엄응용。
Objective To study the preoperative appraisal value of spontaneous intracranial hemorrhage by 64-slices spiral CT subtraction angiography cerebral arteries, mixed cerebral arteriovenous and cerebral venous re-spectively. Methods Retrospective analysis of CTA and DSA examination for 215 patients with spontaneous intrac-erebral hemorrhage at the same time. Results Of 215 cases with intracranial hemorrhage, abnormal blood vessels had not been seen in 14 cases of CTA and DSA, 2 cases with aneurysm by DSA but not been shown by CTA, 3 cases of aneurysms were not detected by both CTA and DSA. CTA and DSA showed abnormal blood vessels in 196 cases , and among these cases, there were 179 cases of aneurysm, 9 cases of arteriovenous malformation, 3 cases of phleban-gioma, and 5 cases of moyamoya disease. Conclusion The application of 64-slices spiral CT subtraction angiography in cerebral arteries, mixed cerebral arteriovenous, cerebral venous in intracranial hemorrhage respectively have great value for preoperative evaluation, which is worthy to applicate popularly.