CT血管造影与磁共振血管造影诊断脑血管痉挛的临床对比研究
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摘要
目的探究与分析CT血管造影与磁共振血管造影诊断脑血管痉挛的临床效果。方法选取2016年5月至2018年5月本院收治的32例急性蛛网膜下腔出血患者,全部患者在出血4～10 d后给予磁共振血管造影检查,在接受完磁共振血管造影检查后的24 h在实施CT血管造影,对比两种方法诊断脑血管痉挛的一致性及检出率。结果 32例患者中,ICA、M1、M2、A1及A2均为双侧,采用CT血管造影与核磁共振对全部5个位置的血管痉挛程度仅诊断时可见一致性达到85%,相关因子为0.78;采用核磁共振造影检查血管无痉挛与重度痉挛的检出率与CT血管造影的相关程度较高(r=0.86～0.92);对于远端血管轻度痉挛及中度痉挛的检出率与CT血管造影的相关度为(r=0.21～0.51)。结论采用磁共振血管造影诊断近端血管无痉挛或者发生了严重痉挛具有较高的检出率,但对远端的血管痉挛检出率较低。
Objective To explore the clinical effects of CT angiography and MRI angiography to diagnose cerebral vasospasm. Methods 32 patients with acute subarachnoid hemorrhage admitted to our hospital from May 2016 to May 2018 were enrolled. All patients underwent magnetic resonance angiography 4 to 10 days after hemorrhage, 24 hours after receiving magnetic resonance angiography. In the implementation of CT angiography, the consistency and detection rate of cerebral vasospasm were compared by two methods. Results Among the 32 patients, ICA, M1, M2, A1 and A2 were bilateral, using CT angiography and magnetic resonance imaging(MRI) on the degree of vasospasm all 5 position diagnosis when only the visible consistency of 85%, the related factor of 0.78; The rate of detection of vasospasm and severe spasm in angiospasm and severe spasm was higher(r=0.86-0.92) with mris. The correlation between the detection rate of mild spasm and moderate spasm in the distal vessels was associated with CT angiography(r=0.21-0.51). Conclusion Using magnetic resonance angiography in the diagnosis of the proximal happened without vessel spasm or severe spasm has high detection rate, but on the far side of vasospasm detection rate is low.
Objective To explore the clinical effects of CT angiography and MRI angiography to diagnose cerebral vasospasm. Methods 32 patients with acute subarachnoid hemorrhage admitted to our hospital from May 2016 to May 2018 were enrolled. All patients underwent magnetic resonance angiography 4 to 10 days after hemorrhage, 24 hours after receiving magnetic resonance angiography. In the implementation of CT angiography, the consistency and detection rate of cerebral vasospasm were compared by two methods. Results Among the 32 patients, ICA, M1, M2, A1 and A2 were bilateral, using CT angiography and magnetic resonance imaging(MRI) on the degree of vasospasm all 5 position diagnosis when only the visible consistency of 85%, the related factor of 0.78; The rate of detection of vasospasm and severe spasm in angiospasm and severe spasm was higher(r=0.86-0.92) with mris. The correlation between the detection rate of mild spasm and moderate spasm in the distal vessels was associated with CT angiography(r=0.21-0.51). Conclusion Using magnetic resonance angiography in the diagnosis of the proximal happened without vessel spasm or severe spasm has high detection rate, but on the far side of vasospasm detection rate is low.
引文
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[7]曹音,钱惠农,刘志平,等.经颅多普勒超声诊断脑动脉痉挛与数字减影血管造影的对比研究[J].临床神经病学杂志,2014,17(3):169-171.
[8]冷利华,黄文胜,汪念东,等.无症状心肌缺血患者动态心电图与冠状动脉CT血管造影的对比分析[J].心肺血管病杂志,2013,32(3):20-21.
[9]郎胜坤,马铁柱,郝芊芊,等.CTA联合CT对蛛网膜下腔出血所致脑血管痉挛与迟发性脑缺血的相关性探讨[J].中西医结合心脑血管病杂志,2017,15(2):90-91.
[10]易梅,赵一平,李松柏,等.CT灌注与CT血管成像对蛛网膜下腔出血后脑血管痉挛诊断价值的Meta分析[J].现代生物医学进展,2015,15(29):123-124.
[11]蔡成仕,黄立军.CT血管造影在缺血性脑血管诊断中的应用[J].中国基层医药,2015,22(2):123-124.
[12]刘春岭.CT血管造影在急性脑血管疾病中的诊断价值[J].医药前沿,2017,7(2):123-124.
[13]蔡鸣凡.CT血管造影在神经内科急性脑血管病中的诊断价值[J].中国实用神经疾病杂志,2015,18(1):90-91.
[14]戴李华,刘颖.多层螺旋CT血管造影在脑血管疾病诊断中的研究进展[J].中国临床新医学,2015,8(1):123-124.
[15]周立华,白铁阳,姜波,等.128层螺旋CT血管造影对出血性脑血管疾病病因诊断及对治疗的指导价值[J].中国医药指南,2015,13(29):124-125.
[16]胡元明钦,魏玮,李春生,等.脑血管痉挛螺旋CT血管造影临床应用[J].中国CT和MRI杂志,2005,3(2):4-6.
[2]阎维维,佟小光,杜毅.尼莫地平不同给药途径治疗外伤性蛛网膜下腔出血的疗效评价[J].中国医药,2012,7(6):696-698.
[3]锦泉,王建莉,张华亮.颅脑创伤后脑血管痉挛的诊断及治疗体会[J].中华神经外科杂志,2012,28(7):671-673.
[4]迎辉,刘绍明.颅脑创伤后脑缺血性损伤研究进展[J].中华神经外科疾病研究杂志,2013,12(1):84-86.
[5]谢光辉,张春兰.数字减影血管造影和CT血管造影在脑动脉瘤诊断中的应用价值比较[J].实用心脑血管病杂志,2015,23(1):90-91.
[6]李伟钦,郑华英,朱玉莉,等.蛛网膜下腔出血后脑痉挛的临床研究及CT征象分析[J].中国CT和MRI杂志,2016,14(7):12-14.
[7]曹音,钱惠农,刘志平,等.经颅多普勒超声诊断脑动脉痉挛与数字减影血管造影的对比研究[J].临床神经病学杂志,2014,17(3):169-171.
[8]冷利华,黄文胜,汪念东,等.无症状心肌缺血患者动态心电图与冠状动脉CT血管造影的对比分析[J].心肺血管病杂志,2013,32(3):20-21.
[9]郎胜坤,马铁柱,郝芊芊,等.CTA联合CT对蛛网膜下腔出血所致脑血管痉挛与迟发性脑缺血的相关性探讨[J].中西医结合心脑血管病杂志,2017,15(2):90-91.
[10]易梅,赵一平,李松柏,等.CT灌注与CT血管成像对蛛网膜下腔出血后脑血管痉挛诊断价值的Meta分析[J].现代生物医学进展,2015,15(29):123-124.
[11]蔡成仕,黄立军.CT血管造影在缺血性脑血管诊断中的应用[J].中国基层医药,2015,22(2):123-124.
[12]刘春岭.CT血管造影在急性脑血管疾病中的诊断价值[J].医药前沿,2017,7(2):123-124.
[13]蔡鸣凡.CT血管造影在神经内科急性脑血管病中的诊断价值[J].中国实用神经疾病杂志,2015,18(1):90-91.
[14]戴李华,刘颖.多层螺旋CT血管造影在脑血管疾病诊断中的研究进展[J].中国临床新医学,2015,8(1):123-124.
[15]周立华,白铁阳,姜波,等.128层螺旋CT血管造影对出血性脑血管疾病病因诊断及对治疗的指导价值[J].中国医药指南,2015,13(29):124-125.
[16]胡元明钦,魏玮,李春生,等.脑血管痉挛螺旋CT血管造影临床应用[J].中国CT和MRI杂志,2005,3(2):4-6.