Computed Tomographic Angiography Detection of Active Spontaneous Intracerebral Hemorrhage

電腦斷層血管造影偵測正在出血之自發性腦出血

李超群(Chau-Chin Lee) ； 楊雅惠(Ya-Hui Yang) ； 陳震宇(Chen-Yu Cheng) ； 龔敏凱(Min-Kai Kung) ； 張寶源(Pau-Yuan Chang) ； 魏妙俶(Mew-Chi Wei) ； 賴惠文(Amy Lai) ； 彭文君(Wen-Chun Peng)

《中華放射線醫學雜誌》 23卷4期 (1998/08) Pp. 155-158

摘要

有兩位自發性腦出血患者接受電腦斷層血管造影(CTA), CTA原始影像(source image)顯示對比劑滲漏，最大亮度投影影像排除可見之動靜脈畸形及動脈瘤。他們均在數小時內病況惡化，且接受緊急手術治療，術後病況明顯改善。但其中一位於轉出加護病房後發生缺氧事件。我們認為CTA原始影像顯示對比劑滲漏可能是正在出血，可預測患者病情急會急劇惡化，提醒神經外科醫師需隨時準備手術

關鍵字

電腦斷層血管造影 ； 自發性腦出血 ； 正在出血

並列摘要

Case Summary: We report two cases of spontaneous intracerebral hemorrhage with active bleeding detected by computed tomographic angiography (CTA). Both cases had CTA within 24 hours of the onset of clinical symptoms. The active bleeding presented as a spot of contrast media extravasation in source images. There was no visible arteriovenous malformation or aneurysm in maximum intensity projection images. Neurosurgeons were alerted to possible rapid progression of the disease process. Acute deterioration due to significant increase in hematoma size in a few hours was found by follow up CT in one case and by operative finding in the other. Both patients had emergency surgery with fair post-operative results. Unfortunately, one patient had a hypoxic event during the postoperative period. We think active extravasation detected by CTA is important in predicting deterioration of a patient's condition and encouraging early intervention.

並列關鍵字

CT ； three-dimensional ； brain ； hemorrhage