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周脑外非动脉瘤次关节出血:是否需要重复数字减去血管造影?

Rosa Schubert¹, Maharani Budi Santoso², Yan Li²

¹Institute for Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Essen, Germany. rosa.schubert@stud.uni-due.de.

|September 26, 2025

概括

重复数字减去血管造影 (DSA) 对于周脑非动脉瘤下关节出血 (PMSAH) 的诊断产量低,并带有并发症风险. 在典型的PMSAH病例中,非侵入性成像是重复DSA的首选.

科学领域:

神经学神经学
神经辐射学神经辐射学
血管成像血管成像

背景情况:

自发性周脑非动脉瘤次结节出血 (PMSAH) 是次结节出血的一种特定亚型.
对于PMSAH的诊断工作通常涉及最初的非对比CT,CTA和DSA.

研究的目的:

评估PMSAH患者重复数字减去血管学 (DSA) 的诊断产量和临床相关性.
在这个患者队列中评估与DSA手术相关的并发症率.

主要方法:

对82名被诊断为PMSAH的患者进行了回顾性分析.
最初的计算机断层扫描血管造影 (CTA) 和第一个DSA在24小时内进行.
第二次DSA在10-14天后进行,如果最初没有识别出出血源.

主要成果:

最初的DSA在92.7%的患者中没有显示出血管异常.
重复DSA发现了两个小动脉瘤 (3.3%),最初的CTA和DSA错过了.
与DSA相关的并发症发生在2%的手术中.

结论:

在典型的PMSAH病例中,重复DSA提供了有限的诊断益处.
DSA并发症的风险超过了大多数PMSAH患者的益处.
对于典型的PMSAH,建议使用高分辨率的非侵入性成像方式,而不是重复DSA.

关键词:

数字减去血管学图.非动脉瘤次结体出血周围大脑脑下arachnoid 出血周围大脑下arachnoid 出血重复血管造影,重复血管造影.

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