Bao Mingyue, Ye Lei, Gao Peng, Cheng Hongwei, Zhang Xing
Department of Neurosurgery, First Affiliated Hospital of Anhui Medical University, Jixi 218, Hefei, 230022, PR China.
Heliyon. 2024 Aug 22;10(17):e36741. doi: 10.1016/j.heliyon.2024.e36741. eCollection 2024 Sep 15.
Identification of potential cerebrovascular disorder in the patient with traumatic subarachnoid hemorrhage (tSAH) is a key element to decrease the complication occurrence and mortality rate. In this study, we aim to compare the diagnostic values between dual-source computed tomography angiography (DSCTA) and traditional tomography angiography (CTA) in identification of potential cerebrovascular disorder among tSAH patients. A total of 113 tSAH patients with the hemorrhage involving more than 2 cisterns were recruited. Among that, 42 patients received DSCTA scans, and another 71 patients received traditional CTA scans. Subsequently, all patients received digital subtraction angiography (DSA) tests to confirm the presence of the cerebrovascular disorder. In DSCTA scan group, 21.4 % (9/42) patients were reported to have cerebrovascular disorders: seven patients had intracranial aneurysms; a patient had pseudoaneurysm with carotid artery cavernous sinus fistula; and a patient had Moyamoya disease. DSA tests had the same results with that with DSCTA scans. In the cohort receiving CTA scans, 19.7 % (14/71) patients were reported to had intracranial aneurysms. However, the positive results of DSA tests for this cohort were 22.5 % (16/71). Two inconsistent results between the CTA scan and DSA test were found, including an arteriovenous malformation and an arteriovenous fistula. In summary, DSCTA and CTA had similar positive rates but differ in diagnostic accuracy for identification of cerebrovascular disorders in tSAH patients.
识别创伤性蛛网膜下腔出血(tSAH)患者潜在的脑血管疾病是降低并发症发生率和死亡率的关键因素。在本研究中,我们旨在比较双源计算机断层扫描血管造影(DSCTA)和传统断层扫描血管造影(CTA)在识别tSAH患者潜在脑血管疾病方面的诊断价值。共招募了113例出血累及2个以上脑池的tSAH患者。其中,42例患者接受了DSCTA扫描,另外71例患者接受了传统CTA扫描。随后,所有患者均接受数字减影血管造影(DSA)检查以确认是否存在脑血管疾病。在DSCTA扫描组中,报告有21.4%(9/42)的患者患有脑血管疾病:7例患者有颅内动脉瘤;1例患者有假性动脉瘤合并颈动脉海绵窦瘘;1例患者有烟雾病。DSA检查结果与DSCTA扫描结果一致。在接受CTA扫描的队列中,报告有19.7%(14/71)的患者有颅内动脉瘤。然而,该队列DSA检查的阳性结果为22.5%(16/71)。发现CTA扫描和DSA检查之间有两个不一致的结果,包括1例动静脉畸形和1例动静脉瘘。总之,DSCTA和CTA在tSAH患者脑血管疾病识别中的阳性率相似,但诊断准确性不同。