CT在脑出血血肿体积动态演变过程中的影像学评估

目的 利用CT观察脑出血血肿体积、血肿吸收率的动态变化规律.方法 根据出血量不同将患者分为A组（出血量＜10 ml）34例；B组（出血量10～20 ml）26例；C组（出血量＞20 ml）16例.采用CT血肿体积测量软件分别在第1、3、7天测量水肿体积,比较同组间第3天与第1天水肿体积差值及第7天与第3天水肿体积差值.结果 三组患者间第3天与第1天水肿体积的差值及第7天与第3天水肿体积的差值比较,差异均有统计学意义（P＜0.05）,且同组间不同时期水肿变化差异也有统计学意义（P＜0.05）.脑出血的血肿吸收率随着时间的延长而增加,第3天明显较第1天增加,且血肿吸收率与首次出血量有关,差异有统计学意义（P＜0.05）.结论 脑出血水肿体积、血肿吸收率与出血后时间、首次出血量有关,随着时间的延长,水肿体积逐渐增大（第1～3天明显）,血肿吸收速度增快；出血量大的患者其水肿增大快、血肿吸收慢；出血量少的患者,其水肿增大慢,血肿吸收快.

CT radiographic assessment in the dynamic evolution process of hematoma volume after cerebral hemorrhage

Objective To observe the dynamic variation rules of hematoma volume and absorptivity after cerebral hemorrhage by computed tomography（CT）. Methods Based on bleeding volume（BV）,all the patients were divided into group A（BV〈10 ml,n=34）,group B（BV between 10 to 20 ml,n=26）,and group C（BV〉 20 ml,n=16）.The edema volume was measured in the lst,3rd,and 7th days by CT hematoma volume measurement software.Besides,the hematoma vol- ume differences between the 1st and 3rd days,and 3rd and 7th days in the same group were compared. Results The hematoma volume differences between the 1st and 3rd days,3rd and 7th days in the same group were significant （P〈 0.05）.There were statistical differences in comparisons of edema changes in varied time among three groups （P〈0.05）. The hematoma absorptivity increased with the progression of time,which increased more in the 3rd day than that in the 1st day.What＇s more,the hematoma absorptivity was related with the bleeding volume in the first time,which displayed a statistical difference （P〈0.05）. Conclusion The edema volume and hematoma absorptivity after cerebral hemorrhage are related with bleeding time and volume in the first time.To be specific,as time develops,the edema volume becomes obviously enlarged in the first three days and the hematoma absorption rate increases.The more the bleeding volume is, the faster the edema volume increases and the slower the hematoma absorption is.The less the bleeding volume is,the slower the edema volume becomes and the faster the hematoma absorption is.