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目的研究动脉瘤性蛛网膜下腔出血的积血部位与动脉瘤部位之间的相关性。方法回顾性分析270例动脉瘤性蛛网膜下腔出血患者的影像学资料,以了解积血部位与动脉瘤部位之间的相关性。结果 270例患者中前交通动脉瘤86例,大脑前动脉瘤19例,头颅CT均显示前纵裂积血;脉络膜前动脉瘤40例,后交通动脉瘤82例,多数在CT上显示广泛鞍上池积血,病变同侧积血多于对侧;大脑中动脉瘤32例,CT多显示病变同侧外侧裂积血;后循环动脉瘤11例,头颅CT多见鞍上池及脑室系统积血;出血量较大时,除具备上述特征外,积血部位更广泛,特异性相对较小。结论动脉瘤性蛛网膜下腔出血的积血部位与动脉瘤部位存在一定的对应关系,根据头颅CT所示积血部位可初步判断动脉瘤的部位,对数字减影血管造影时血管检查顺序的选择及治疗方法的预估有重要价值。
Objective To study the correlation between aneurysm sites and anemic hematoma sites in aneurysmal subarachnoid hemorrhage. Methods A retrospective analysis of 270 cases of aneurysmal subarachnoid hemorrhage in patients with imaging data to understand the site of hematoma and aneurysm site correlation. Results Among the 270 patients, 86 cases had anterior communicating artery aneurysm, 19 anterior cerebral artery aneurysm and cranial CT showed prerenal hemorrhage. There were 40 anterior choroidal aneurysms and 82 a posterior communicating aneurysms, most of them showed extensive saddle on CT The hematoma in the upper pool and the ipsilateral hemorrhage in the lesion were more than those in the contralateral side. Thirty-two cases of middle cerebral artery aneurysm showed ipsilateral lateral hemorrhage with CT and 11 cases of posterior circulation aneurysm. Hemorrhage; larger amount of bleeding, in addition to the above characteristics, the hematocele more extensively, the specificity is relatively small. Conclusion Aneurysmal subarachnoid hemorrhage hematopoietic site and aneurysm site there is a certain correspondence between the site according to the cranial CT hemorrhage can be a preliminary diagnosis of aneurysm site for digital subtraction angiography vascular examination sequence Estimates of choice and treatment have important value.