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1、CT和CTA联合检查在动脉瘤性蛛网膜下腔出血早期的临床价值摘要：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
2、学意义(P❷0.05)。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。关键词：体层摄影术；螺旋计算机；动脉瘤；蛛网膜下腔出血
3、TheEarlyClinicalValueofCombinedCTandCTAinAneurysmalSubarachnoidHemorrhageFUShun-bini,YANGHai-lil,GOUZhen-hengl,RENA-hongl,LILil,SONGYing2(1.DepartmentofAdiology‘People，sHospitalofBeijingDaxingDistriet,Beijing102600,China；2.DepartmentofNeurosurgery,People"sHospit
4、alofBeijingDaxingDistriet,Beijing102600,China)Abstract：ObjectiveToanalyzetheearlydiagnosispotentialityofCTandCTAintheaneurismalsubarachnoidhemorrhage(ASAH)・Methods75casesofaneurismalsubarachnoidhemorrhage(SAH)patientsunderwentCT,computedtomographicangiography(CT
5、A)anddigitalsubstractionangiography(DSA).Relationshipofbleedingmorphologicalcharacteristicandaneurysmsitewasretrospectivelyanalyzed.Thereleanceofsymptomaticcerebralvasospasm(SCVS)andbloodvolumewasdetermined・ThedifferencebetweenCTAandDSAwereretrospectivelyanalyze
6、d・ResultsAccordingtoFishergradingstandards,classI7cases(9.33%),IIgrade17cases(22.67%),IIIgrade32cases(42.67%),IVgrade19cases(25・33%)・Thereweresignificantdifferencesbetweenthebleedingmorphologicalcharacteristicandaneurysmsite(P❷0.05).SCVSoccurredin19cases(25.33%)
7、,theincidenceofSCVSamongdifferentFishergradeswerestatisticallysignificantlydifferent(P<0.05).87aneurysmswerefoundinDSAand85aneurysmswerefoundinCTA・TherewasnosignificantdifferencebetweenCTAandDSA(P>0.05)・ConclusionCTcanindirectlyspeculatethepositionofaneurysm,hel
8、ptodiagnosetheSCVSaccordingFishergradeprospectively.CTAhasgoodconsistencycomparedwithDSA.CTcombinedCTAplayanimportantroleindiagnosingandguidingthetreadmentofASAHandpr
