CAJ | 학술논문

目的评价64层螺旋 CT 血管造影(CTA)在急性自发性颅内出血病因诊断中的价值.资料与方法58例急性颅内出血患者术前采用容积重建(VR)和最大密度投影(MIP)方法进行 CTA 及数字减影血管造影(DSA)检查,并与手术结果相对照.结果58例患者中,DSA及手术证实颅内动脉瘤32例(35个),脑动静脉畸形9例,烟雾病6例,静脉畸形伴海绵状血管瘤1例,静脉窦血栓1例,未发现异常9例.对35个动脉瘤,CTA 正确诊断34个,漏诊1个.1例阴性病例误诊为动脉瘤;1例海绵状血管瘤伴静脉畸形误诊为动静脉畸形.CTA 对9例脑动静脉畸形、1例静脉窦血栓及6例烟雾病均诊断正确.CTA 对急性出血性脑血管病的诊断敏感性为96.3%(52/54),特异性为90.0%(9/10),阳性预测值为98.1%(52/53),阴性预测值为81.8%(9/11),准确性为95.3%(61/64).结论 CTA 对急性自发性颅内出血病因诊断的准确性与 DSA 相近,可作为首选筛查手段.
목적평개64층라선 CT 혈관조영(CTA)재급성자발성로내출혈병인진단중적개치.자료여방법58례급성로내출혈환자술전채용용적중건(VR)화최대밀도투영(MIP)방법진행 CTA 급수자감영혈관조영(DSA)검사,병여수술결과상대조.결과58례환자중,DSA급수술증실로내동맥류32례(35개),뇌동정맥기형9례,연무병6례,정맥기형반해면상혈관류1례,정맥두혈전1례,미발현이상9례.대35개동맥류,CTA 정학진단34개,루진1개.1례음성병례오진위동맥류;1례해면상혈관류반정맥기형오진위동정맥기형.CTA 대9례뇌동정맥기형、1례정맥두혈전급6례연무병균진단정학.CTA 대급성출혈성뇌혈관병적진단민감성위96.3%(52/54),특이성위90.0%(9/10),양성예측치위98.1%(52/53),음성예측치위81.8%(9/11),준학성위95.3%(61/64).결론 CTA 대급성자발성로내출혈병인진단적준학성여 DSA 상근,가작위수선사사수단.
P u r p o s e T o a s s e s s t h e v a l u e o f 6 4-c o m p u t e d t o m o g r a p h y angiography (CTA) in the detection of acute spontaneous intracerebral hemorrhage (ICH). Materials and Methods 58 consecutive patients with spontaneous ICH underwent 3D-CTA. Original CT data were transferred to workstation for reconstruction and were displayed on volume rendered (VR) and maximum intensity projection (MIP) images. The results were compared with pathological results. Results Forty-nine of the 58 patients demonstrated angiographic abnormalities, including aneurysms (n=32), arteriovenous malformations (n=9), moyamoya disease (n=6), cavernous hemangioma with developmental venous anomaly (n=1) and cereberal venous sinus thrombosis (n=1). CTA detected 34 aneurysms correctly except one case of small aneurysm. One case of cavernous hemangioma with developmental venous anomaly was misdiagnosed as arteriovenous malformations. The overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CTA were 96.3% (52/54), 90.0% (9/10), 98.1% (52/53), 81.8%(9/11) and 95.3% (61/64), respectively. Conclusion 64-slice spiral CTA is nearly as accurate as DSA in determining the cause of acute spontaneous ICH and can be used as the first screening test in patients presenting with spontaneous ICH.