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目的探讨多层螺旋CT血管造影(MSCTA)在急性自发性颅内出血中的应用价值。方法CT诊断急性自发性颅内出血41例,其中蛛网膜下腔出血29例、脑内血肿12例,采用容积重建(VR)和最大密度投影(MIP)方法进行MSCTA检查,并对7例颅内动脉瘤钛夹夹闭术病例和2例脑动静脉畸形、1例脑动静脉畸形伴巢内动脉瘤手术切除病例进行术后MSCTA评价。结果41例急性自发性颅内出血中,MSCTA检查出颅内动脉瘤11例、脑动静脉畸形4例、脑动静脉畸形伴巢内动脉瘤1例;MSCTA对动脉瘤的瘤体大小、瘤颈、载瘤动脉和脑动静脉畸形的部位、大小、瘤巢的形态、供血动脉和引流静脉的显示均较清楚。7例动脉瘤行钛夹夹闭术和2例脑动静脉畸形、1例脑动静脉畸形伴巢内动脉瘤行手术切除,手术所见与术前MSCTA表现相符;术后行MSCTA复查,显示夹闭动脉瘤之钛夹位置正常,载瘤动脉、颅内大血管通畅,脑动静脉畸形之瘤巢已切除。结论MSCTA是急性自发性颅内出血病因诊断的一种无创伤、快捷有效的影像学方法,并且在颅内动脉瘤、脑动静脉畸形术后评价方面也具有临床应用价值。
Objective To investigate the value of multi-slice spiral CT angiography (MSCTA) in acute spontaneous intracranial hemorrhage. Methods CT was performed in 41 cases of acute spontaneous intracranial hemorrhage, including 29 cases of subarachnoid hemorrhage and 12 cases of intracerebral hematoma. MSC and MSCT were performed by volume reconstruction (VR) and maximum density projection (MIP) Postoperative MSCTA was performed on the cases of aneurysm occlusion of titanium clips and two cases of cerebral arteriovenous malformations and one case of cerebral arteriovenous malformation with surgical removal of aneurysm. Results In 41 cases of acute spontaneous intracranial hemorrhage, 11 cases of intracranial aneurysms, 4 cases of cerebral arteriovenous malformations and 1 case of cerebral arteriovenous malformations were diagnosed by MSCTA. The tumor size, , Tumor-bearing artery and cerebral arteriovenous malformations of the site, size, tumor nests morphology, blood supply artery and drainage veins are more clearly displayed. 7 cases of aneurysm were treated with titanium clips and 2 cases of cerebral arteriovenous malformations, 1 case of cerebral arteriovenous malformations with intracavitary aneurysms were surgically removed, the findings were consistent with the preoperative MSCTA; postoperative MSCTA review showed Clipped aneurysm titanium clip normal position, the parent artery, intracranial vascular patency, cerebral arteriovenous malformation of the tumor nests have been removed. Conclusion MSCTA is a noninvasive, efficient and effective imaging method for the diagnosis of acute spontaneous intracranial hemorrhage. It also has clinical value in the postoperative evaluation of intracranial aneurysms and cerebral arteriovenous malformations.