目的分析数字减影CTA在自发性 蛛网膜下腔出血诊断中的价值。方法 选 取2017年3月至2018年3月我院收治的自 发性蛛网膜下腔出血患者200例为研究对 象，均进行三维数字减影血管造影(DSA) 及数字减影CTA(简称减影CTA)检查，对比 减影CTA与DSA的图像质量、显示效果，并 以DSA为金标准，分析减影CTA的诊断效 能，比较其动脉瘤测量数据。结果 本组 中DSA发现动脉瘤157例，脑动静脉畸形 (AVM)10例，Moyamoya病5例，阴性者28 例，CTA检查发现动脉瘤147例，AVM 10 例，Moyamoya病5例，阴性者38例，其中 误诊动脉瘤4例，漏诊动脉瘤14例；减 影CTA、DSA图像质量比较,差异无统计 学意义(P＞0.05)；减影CTA诊断SAH的灵 敏度、特异度、准确度分别为91.86%、 85.71%、91.00%；CTA与DSA测定的动脉 瘤、瘤口直径比较差异均无统计学意义 (P＞0.05)。结论 数字减影CTA在自发 性蛛网膜下腔出血诊断中有较高应用价 值，可作为常用诊断方法之一。

Objective To analyze the value of digital subtraction CTA in the diagnosis of spontaneous subarachnoid hemorrhage (SAH). Methods A total of 200 patients with spontaneous SAH who were admitted to the hospital from March 2017 to March 2018 were selected as the study subjects. Three-dimensional digital subtraction angiography (DSA) and digital subtraction CTA (subtraction CTA) were performed. The image quality and display effect were compared between subtraction CTA and DSA. With DSA as the golden standard, the diagnostic efficiency of subtraction CTA was analyzed and the measured data of aneurysms were compared. Results There were 157 cases of aneurysms, 10 cases of cerebral arteriovenous malformations (AVM), 5 cases of Moyamoya disease and 28 negative cases detected by DSA. 147 cases of aneurysms, 10 cases of AVM, 5 cases of Moyamoya diseaseand 38negative cases were detected by CTA.4 cases of aneurysmswere misdiagnosedand 14 cases were missed. There was no significant difference in the image quality between subtraction CTA and DSA (P>0.05). The sensitivity, specificity and accuracy of subtraction CTA in the diagnosis of SAH were 91.86%, 85.71% and 91.00%, respectively. There was no significant difference in the diameter of aneurysms and tumors measured by CTA and DSA (P>0.05). Conclusion Digital subtraction CTA is of great value in the diagnosis of spontaneous SAH. It can be used as one of the commonly used diagnostic method.