Hayman L A, Fox A J, Evans R A
AJNR Am J Neuroradiol. 1981 Sep-Oct;2(5):421-5.
Forty-three patients with cerebral vascular malformation were studied with precontrast, immediate contrast, and 1 hr delayed high dose contrast computed tomography (CT) scans. The precontrast scans were abnormal in 81% of patients. The delayed high dose scans demonstrated one angiographically occult, thrombosed arteriovenous malformation not seen on pre- or immediate contrast scans, four cases with additional zones of encapsulated hemorrhage or infarction not seen on pre- or immediate contrast CT, and two cases of venous angiomas seen on immediate contrast scans but not on delayed high dose scans. In 50% of patients, large vessels surrounding the malformation faded on the delayed dose scans which were less specific for vascular malformation than immediate contrast CT. We conclude that: (1) delayed high dose scans offer no significant advantage in patients with symptoms suggesting vascular malformation of the brain; and (2) while less specific than immediate contrast CT, these scans do not preclude detection of vascular malformations of the brain. Therefore, delayed high dose CT can be used in patients with suspected blood-brain barrier lesions without fear of missing vascular malformations.
对43例脑血管畸形患者进行了平扫、增强即刻扫描及1小时延迟高剂量增强计算机断层扫描（CT）。81%的患者平扫异常。延迟高剂量扫描显示出1例在平扫或增强即刻扫描中未见的血管造影隐匿性血栓形成的动静脉畸形，4例在平扫或增强即刻CT中未见的额外的包膜下出血或梗死区域，以及2例在增强即刻扫描中可见但在延迟高剂量扫描中未见的静脉瘤。50%的患者中，畸形周围的大血管在延迟剂量扫描中变淡，延迟剂量扫描对血管畸形的特异性低于增强即刻CT。我们得出结论：（1）对于有提示脑血管畸形症状的患者，延迟高剂量扫描没有显著优势；（2）虽然这些扫描比增强即刻CT特异性低，但并不排除检测到脑血管畸形。因此，延迟高剂量CT可用于疑似血脑屏障病变的患者，而不用担心漏诊血管畸形。
