目的：探讨多层螺旋CT血管成像（MSCTA）在自发性颅内出血病因诊断中的应用价值。方法：对我院收治的69例自发性颅内出血患者的影像学资料进行回顾性分析，所有患者均行MSCTA检查，36例CTA检查为动脉瘤的患者进行了DSA检查并对责任动脉瘤行栓塞治疗。结果：MSCTA诊断动脉瘤36例，烟雾病13例，动静脉畸形8例；DSA和栓塞手术结果证实：MSCTA诊断动脉瘤正确33例，误诊1例，漏诊2例，其对动脉瘤患者的诊断准确性为91.7%；不同出血部位出血原因分析表明：蛛网膜下腔出血主要由动脉瘤破裂所致，脑室出血大多由烟雾病引起，脑叶出血主要原因为脑血管畸形，脑深部出血主要原因为烟雾病，混合性出血可由动脉瘤和血管畸形引起。结论：MSCTA在自发性颅内出血病因诊断中具有重要价值。

Objective: To evaluate the value of multi-slice spiral CT angiography(MSCTA) in the etiological diagnosis of spontaneous intracranial hemorrhage. Methods: We retrospectively analyzed the imaging data of 69 cases spontaneous intracranial hemorrhage. All patients underwent MSCTA examination, including 36 patients with aneurysm who underwent DSA and the embolization therapy of responsibility aneurysms. Results: We diagnosed 36 cases of aneurysm, 13 cases of moyamoya disease, and 8 cases of arteriovenous malformations by MSCTA, but 33 cases of aneurysm was confirmed by DSA and embolization, one of misdiagnosis and 2 cases of miss diagnosis, with the diagnostic accuracy of 91.7% in patients with aneurysms. The cause analysis of bleeding in different bleeding positions showed that subarachnoid hemorrhage was mainly caused by the ruptured of aneurysm, ventricular hemorrhage was mostly caused by moyamoya disease, the main reason of the lobar hemorrhage was cerebral vascular malformations, the main reason of deep cerebral hemorrhage was caused by moyamoya disease. Mixed hemorrhage could be caused by aneurysm and vascular malformations. Conclusion: MSCTA has an important value in the etiological diagnosis of spontaneous intracranial hemorrhage.