自发性脑内出血患者的计算机断层扫描血管造影诊断率。

IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Acta radiologica Pub Date : 2024-07-01 Epub Date: 2024-05-21 DOI:10.1177/02841851241254516
Maria Kjølhede, Niels Hjort, Sif Homburg, Morten Nørholt, Rikke Beese Dalby, Claus Ziegler Simonsen, Rolf Ankerlund Blauenfeldt
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引用次数: 0

摘要

背景:高血压和脑淀粉样血管病是自发性脑出血(ICH)最常见的病因,但这些疾病并不意味着大血管病变。尽管如此,计算机断层扫描(CT)血管造影术(CTA)仍经常在 ICH 患者的急性期进行。目的:评估 CTA 对自发性 ICH 连续患者继发性病因检测的诊断率:我们对一项前瞻性单中心队列研究的数据进行了回顾性分析,研究对象是两年内(2016 年 10 月 15 日至 2018 年 10 月 15 日)入住综合卒中中心的 203 名自发性 ICH 患者。研究使用 CTA 评估了潜在的血管病理学:除非对比 CT 和/或磁共振成像 (MRI) 外,还进行了 CTA。203例患者中有11例(5.4%)发现血管病变,包括动静脉畸形(4例)、动脉瘤(4例)、血管痉挛(1例)、脑静脉血栓(1例)和其他血管畸形(1例)。8例患者的检查结果被认为是无症状的。CTA检查发现血管病变的患者多伴有脑叶出血(63.6% 对 36.4%,P = 0.049)。从数字上看,血管病变患者更年轻、血肿体积更小、死亡率更低:结论:在连续 20 例 ICH 患者中,只有约 1 例能通过 CTA 检测到潜在的大血管病变。血管病变患者的出血部位多为叶状,且年龄较小,本研究支持在进行 CTA 时采用基于风险的分层方法。
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Diagnostic yield of computed tomography angiography in patients presenting with spontaneous intracerebral hemorrhage.

Background: Hypertension and cerebral amyloid angiopathy are the most common causes of spontaneous intracerebral hemorrhage (ICH); however, these conditions do not imply macrovascular pathology. Still, computed tomography (CT) angiography (CTA) is often performed in the acute phase in patients with ICH.

Purpose: To assess the diagnostic yield of CTA in the detection of secondary etiology in consecutive patients with spontaneous ICH.

Material and methods: We performed a retrospective analysis of data from a prospective single-center cohort study of 203 patients presenting with spontaneous ICH admitted to a comprehensive stroke center over a two-year period (15 October 2016 to 15 October 2018). The underlying vascular pathology was assessed using CTA.

Results: CTA was performed in addition to non-contrast CT and/or magnetic resonance imaging (MRI). Vascular pathology was found in 11 of 203 (5.4%) patients and included arteriovenous malformations (n=4), aneurysms (n=4), vasospasms (n=1), cerebral venous thrombosis (n=1), and other vascular malformations (n=1). In eight cases, the finding was deemed symptomatic. Patients with vascular pathology on CTA more often had lobar located hemorrhages (63.6% vs. 36.4%, P = 0.049). Numerically, patients with vascular pathology were younger, had smaller hematoma volumes, and lower mortality.

Conclusion: Underlying macrovascular pathology was detected on CTA in only approximately 1 of 20 consecutive patients with ICH. The patients with vascular pathology more often had a hemorrhage with a lobar location and young age and the present study is supportive of a risk-based stratification approach in performing CTA.

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来源期刊
Acta radiologica
Acta radiologica 医学-核医学
CiteScore
2.70
自引率
0.00%
发文量
170
审稿时长
3-8 weeks
期刊介绍: Acta Radiologica publishes articles on all aspects of radiology, from clinical radiology to experimental work. It is known for articles based on experimental work and contrast media research, giving priority to scientific original papers. The distinguished international editorial board also invite review articles, short communications and technical and instrumental notes.
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