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目的:探讨CT复查在迟发性外伤性脑内血肿(DTICH)诊断中的作用。方法:回顾性分析2012年4月至2015年7月东莞市石碣镇医院确诊治疗的DTICH患者38例,所有患者均采用飞利浦16排螺旋CT进行检查和给予脑内迟发型血肿清除术治疗,首次CT检查在外伤后0.5~3.0 h进行,CT复查在外伤后12~72 h,统计分析两次CT表现特点。结果:所有患者首次CT检查时未发现脑内血肿征象,其中CT表现特点为灰白质不清的低密度影17例、局部轻度脑占位效应15例、蛛网膜下腔出血21例、硬膜下血肿7例、硬膜外血肿2例;所有患者CT复查时均出现脑内血肿,其中CT表现特点为额叶血肿20例、颞叶8例、顶叶3例、枕叶3例。结论:DTICH患者脑内血肿发发生较晚,脑外伤发生后首次CT检查时发现灰白质不清的低密度影、蛛网膜下腔出血、硬膜下血肿、硬膜外血肿,可通过CT复查提高诊断DTICH的准确性。
Objective: To investigate the role of CT in the diagnosis of delayed traumatic intracerebral hematoma (DTICH). Methods: 38 patients with DTICH diagnosed and treated in Shijiezhen Hospital of Dongguan City from April 2012 to July 2015 were retrospectively analyzed. All patients were examined by Philips 16-slice spiral CT and delayed intracerebral hematoma removal, The first CT examination was performed at 0.5-3.0 h after trauma. The CT scan was performed at 12-72 h after trauma. The CT findings were analyzed twice. Results: No signs of intracerebral hematoma were found on the first CT examination in all patients. Among them, 17 cases were characterized by low density of gray matter, 15 cases of local mild brain mass, 21 cases of subarachnoid hemorrhage, 7 cases of subdural hematoma, 2 cases of epidural hematoma; all patients with intracranial hematoma appeared in the CT review, which CT features of frontal hematoma in 20 cases, 8 cases of temporal lobe, 3 cases of parietal and 3 cases of occipital lobe. Conclusions: Cerebral hematoma occurred later in patients with DTICH. Low density of gray matter, subarachnoid hemorrhage, subdural hematoma and epidural hematoma were found on the first CT examination after traumatic brain injury and could be confirmed by CT Improve diagnostic DTICH accuracy.