Vanninen R L, Hernesniemi J A, Puranen M I, Ronkainen A
Department of Clinical Radiology, University Hospital of Kuopio, Finland.
Neurosurgery. 1996 Apr;38(4):838-40; discussion 840-1.
To emphasize the limitations of magnetic resonance angiographic screening for intracranial aneurysms, we present the case of a patient with a false-negative screening result, unfortunately advancing to rupture of the aneurysm. An asymptomatic woman underwent magnetic resonance angiographic screening in an investigational setting. Three years later, she had an onset of sudden headache, after which her condition rapidly deteriorated. Severe subarachnoid hemorrhage and an intracerebral hematoma were diagnosed. Conventional angiography detected a small ruptured middle cerebral artery trifurcation aneurysm and two very small aneurysms. There are still limitations in the ability of magnetic resonance angiography to detect small or very small aneurysms. Even small-probability findings should always be confirmed or excluded by conventional angiography.
为强调磁共振血管造影筛查颅内动脉瘤的局限性，我们报告一例筛查结果为假阴性的患者病例，该动脉瘤不幸破裂。一名无症状女性在一项研究中接受了磁共振血管造影筛查。三年后，她突然出现头痛，随后病情迅速恶化。诊断为严重蛛网膜下腔出血和脑内血肿。传统血管造影发现一个破裂的大脑中动脉三叉处小动脉瘤和两个非常小的动脉瘤。磁共振血管造影检测小或非常小的动脉瘤的能力仍存在局限性。即使是小概率发现也应始终通过传统血管造影进行确认或排除。
