目的 探讨头颅双能量CTA成像 在活动性脑出血诊治中的应用价值。方 法 收集我院2012年2月至2016年6月收治 的脑出血患者展开回顾性分析，记录患 者的血肿形态、部位与体积，比较融合 碘图诊断法与非线性融合图诊断法诊断 活动性脑出血的诊断敏感度及特异度。 结果 76例患者中，50例为规则血肿、26 例不规则。其中丘脑及基底节区44例、 脑叶区21例、幕下11例。18例活动性出 血、58例非活动性出血。融合碘图诊断 法诊断活动性脑出血的敏感度为94.4%， 高于非线性融合图诊断法的66.7%(P﹤ 0.05)；融合碘图诊断法的特异度为 96.6%，非线性融合图诊断法为93.1%， 差异无统计学意义(P＞0.05)。结论 双 能量CTA融合碘图的应用可提高对活动性 脑出血的诊断敏感度，及时行头颅双能 量CTA成像可为后续治疗提供指导。

Objective To investigate the application value of head dual-energy CTA in the diagnosis and treatment of active cerebral hemorrhage. Methods Patients with cerebral hemorrhage admitted in our hospital between February 2012 and June 2016 were analyzed retrospectively. The shape, location and volume of hematoma were recorded. The sensitivity and specificity were compared between fusion iodine graph and nonlinear fusion graph in the diagnosis of active cerebral hemorrhage. Results Among 76 cases, 50 cases had regular hematoma, and 26 cases had irregular hematoma. There were 44 cases with hematoma in thalamus and basal ganglia, 21 cases in lobar area and 11 cases in subtentorial area. There were 18 cases with active hemorrhage and 58 cases with non active hemorrhage. The sensitivity of fusion iodine graph in the diagnosis of active cerebral hemorrhage (94.4%) was higher than that of nonlinear fusion graph (66.7%) (P<0.05). The diagnostic specificity of fusion iodine graph was 96.6% while of nonlinear fusion graph was 93.1%(P>0.05). Conclusion The application of dual-energy CTA fusion iodine graph can improve the sensitivity in the diagnosis of active cerebral hemorrhage. Timely use of dual-energy CTA can provide guidance for the follow-up treatment.