论文部分内容阅读
目的:探讨二次造影对首次血管造影阴性的自发性蛛网膜下腔出血(Subarachnoid hemorrhage,SAH)的价值。方法:回顾性分析2009年7月至2011年7月我院共收治的自发性蛛网膜下腔出血患者115例,在确诊蛛网膜下腔出血后1-3天行股动脉插管全脑血管造影并3D重建和颅脑CT平扫。首次DSA结果阴性者于2-8周行二次全脑血管造影。结果:115例中83例共发现颅内动脉瘤87个,9例为脑血管畸形、Moyamoya病等,23例首次造影阴性。但23颅脑CT显示弥漫性蛛网膜下腔出血16例,中脑周围蛛网膜下腔出血5例,局限于一个脑池或脑叶内蛛网膜下腔出血1例,颅脑CT阴性1例。二次造影后在16例弥漫性蛛网膜下腔出血患者中共发现动脉瘤3例。结论:二次造影对首次血管造影阴性的自发性蛛网膜下腔出血患者具有较高的临床意义,尤其是对于首次造影高度怀疑动脉瘤的弥漫性蛛网膜下腔出血患者,进行二次造影是必要的。
Objective: To investigate the value of second-pass angiography for the first negative angiography of subarachnoid hemorrhage (SAH). Methods: A retrospective analysis of 115 cases of spontaneous subarachnoid hemorrhage in our hospital from July 2009 to July 2011 was performed. The femoral artery was cannulated with whole cerebrovascular vessels 1-3 days after the diagnosis of subarachnoid hemorrhage Contrast and 3D reconstruction and brain CT scan. The first DSA-negative patients underwent total cerebral angiography at 2-8 weeks. Results: 83 of 115 cases were found intracranial aneurysms in 87, 9 cases of cerebrovascular malformations, Moyamoya disease, 23 cases were negative for the first time. However, 23 brain CT showed diffuse subarachnoid hemorrhage in 16 cases, 5 cases of subarachnoid hemorrhage around the midbrain confined to a brain pool or intracerebral hemorrhage in 1 case, 1 case of brain CT negative . Three cases of aneurysm were found in 16 patients with diffuse subarachnoid hemorrhage after secondary angiography. CONCLUSIONS: Secondary angiography is of high clinical significance in patients with first-time angiography negative spontaneous subarachnoid hemorrhage, especially for patients with diffuse subarachnoid hemorrhage who are highly suspected of aneurysm for the first time. necessary.