CT在血友病患者髂腰肌出血中的表现与临床意义

目的 探讨血友病髂腰肌血肿的CT 诊断及临床意义。方法 对17例血友病髂腰肌出血患者均进行1次或多次CT检查，并对血肿的发病部位、大小、形状、密度、与周围组织间关系、影像学特征进行回顾性分析。结果 17例患者CT检查均可见髂腰肌内不同密度的块状或结节状血肿影，其中左侧髂腰肌出血9例（53%）、右侧5例（29%），双侧出血3例（18%）。共发现类圆形、椭圆形或不规则形血肿20个，其中急性期血肿10个（50%），呈高密度影，CT值为66～70 Hu，平均（68.54±3.27）Hu；亚急性血肿8个（40%），呈稍高密度影，CT值为51～65 Hu，平均（59.1±7.95）Hu；慢性期血肿2个（10%），呈低或等密度影，CT值为38～50 Hu，平均44 Hu。经CT测量计算，初发血肿血量为68～766 mL,平均（222.74±166.40）mL。结论 CT不但可以诊断血友病髂腰肌血肿，而且可以为临床正确诊疗提供许多有价值的信息。

Iliopsoas Haemorrhage in Patients with Haemophilia：CT Features and Clinical Significance

Objective To explore the CT diagnosis and clinical significance of iliopsoas hematoma in patients with haemophilia. Methods Seventeen hemophilia patients with iliopsoas hematoma underwent CT scan one or more times.Hematomas location,size,shape,density,relationship to surrounding tissue and imaging characteristics were analyzed retrospectively.Results Different densities of massive or nodular hematoma shadow were observed in the iliopsoas muscle in all patients. Among the 17 patients,left iliopsoas haemorrhage occurred in 9（53%）,right iliopsoas haemorrhage occurred in 5 （29%）, and bilateral iliopsoas haemorrhage in 3 （18%）.A total of 20 quasi-circular, oval or irregularly shaped hematomas were found. Among them, 10 hematomas（50%） in acute stage showed high signal density CT value 66-70 Hu; average （68.54±3.27） Hu], 8 hematomas （40%） in subacute stage showed slightly high signal density CT value 51-65 Hu;average （59.13±7.95） Hu], and 2 hematomas （10%） in chronic stage showed low or equal signal density （CT value 38-50 Hu; average 44 Hu）. The initial hematoma blood ranged from 68 to 766 mL average （222.74±166.40） mL].Conclusion CT scanning can provide valuable information for the correct clinical diagnosis and treatment of iliopsoas hematoma in patients with haemophilia.