急性硬膜外血肿CT诊断中窗技术的应用

目的选择适合观察急性硬膜外血肿的窗宽、窗位。方法病例29例，男27例，女2例，年龄5～80岁，平均38岁。选用适当窗宽、窗位进行扫描。结果在29例急性硬膜外血肿中，6例单纯急性硬膜外血肿；23例或（和）伴颅骨骨折、颅内积气、颅脑复合损伤等。结论应用窗技术适当调高窗位、调宽窗宽，使急性硬膜外血肿清楚显示。     

不典型急性硬膜外与硬膜下血肿的CT鉴别

目的:探讨颅脑损伤不典型急性硬膜外与硬膜下血肿的CT影像学特征及鉴别要点。方法:回顾性分析CT影像学表现不典型的79例病例,与术中证实或后期CT复查及MRI等的确诊结果相比较、分析。结果:首次CT平扫检查误诊率较高。结论:不典型急性硬膜外与硬膜下血肿在CT影像学鉴别诊断上相对困难,需要较高的技巧,有时需要CT复查或MRI检查及相关临床资料辅助。     

等密度硬膜下血肿CT诊断27例分析

我院2005—10～2006—08经手术证实的等密度硬膜下血肿（ISDH）27例，进行回顾性分析如下。 1临床资料 1．1一般资料本组男20例，女7例，年龄43～73（平均62）岁，以56～77岁常见，就诊时有明确外伤史者1例，经仔细追问有轻微外伤史者20例，否认外伤史者6例。从出现症状或外伤后到CT检查时间为2d～4个月，其中有2例为外伤后3d检查，临床表现均有不同程度头痛、恶心、呕吐、肢体运动、感觉障碍及肌力下降等，临床表现相对较轻微而血肿一般较大，表现为症状与体征不符。     

自发性颈部脊髓硬膜外血肿1例

患者,男,53岁,因突发左侧肩背痛伴左侧肢体力弱1小时于2010年11月28日23时入院。患者入院前1小时打麻将时突发左肩背及左上肢疼痛不适,活动肩背后疼痛有所减轻,约30分钟后疼痛加重,继之左侧肢体乏力,渐加重至不能行走,无头痛头晕,无恶心呕吐,无二便障碍,     

颅骨骨膜下血肿17例CT表现分析

目的：回顾性分析17例颅骨骨膜下血肿的CT表现,以提高早期与正确诊断。方法：采用GE 9800及GElight speed螺旋扫描机,以OM为基线向上连续扫描,层厚、间距7~10 mm。结果：17例共18个孤立的骨膜下血肿,均未跨越颅缝,全部位于顶部。1-2周内呈镰状高密度影,紧贴颅板,密度均匀;3-5周的血肿,包膜机化呈厚薄均匀的线状、条带状更高密度影;6周以上的血肿包膜不规则增厚与颅骨呈双层状改变,经过更长时间的塑形血肿成为颅骨的一部分。结论：颅骨骨膜下血肿的CT表现有特征性,能较X线更早地发现并明确诊断。     

超急性硬膜外活动性出血的非典型CT表现

CT对于颅脑外伤病变的显示是十分有效的 ,特别是对需要手术治疗的超急性颅内外病灶的显示效果更佳。对急性血肿的观察 CT当属首选 ,典型的急性外伤性硬膜外出血的 CT表现为广大医师所熟悉 ,但非典型 CT表现 ,尤其是活动性出血的表现及诊断体会鲜有报道 ,易被忽视 ,进而漏诊 ,延误治疗 ,影响愈后 ,有鉴于此 ,回顾性分析 14 7例无典型表现的外伤性硬膜外出血的 CT资料 ,探讨其 CT表现 ,分析漏诊原因。1　对象和方法1.1　对象　本组入选标准　 1自 1992～ 2 0 0 1年我院以急性头外伤收住院的患者中伤后 2 4 h行 CT检查者 ;2首次 CT表现…     

等密度硬膜下血肿42例CT诊断分析

目的：提高对等密度硬膜下血肿的认识。方法：对我院42例术前CT诊断为等密度硬膜下血肿病例进行回顾性分析。结果：42例等密度硬膜下血肿术前CT均诊断正确。结论：等密度硬膜下血肿与血肿存在的时间、硬脑膜一皮层间虹桥静脉破裂、蛛网膜破裂、脑脊液进入血肿及贫血等因素有关;期间接征象在等密度硬膜下血肿CT诊断中起着重要作用。     

等密度硬膜下血肿的CT诊断

目的 回顾性分析等密度硬膜下血肿的CT表现,提高对本病的诊断水平.方法 收集经手术证实的等密度硬膜下血肿35例,分析其CT表现.结果 主要CT征象包括:血肿等密度、脑室变形、脑沟消失、灰白质界面内移.结论 脑室、脑池及脑沟的变形移位及灰白质界面内移是诊断等密度硬膜下血肿的重要CT征象.     

不典型少量急性硬膜下血肿CT诊断(附30例报告)

目的:提高对不典型少量硬膜下血肿的CT征象认识及正确诊断。方法:30例头部外伤患者于伤后24小时内行头部CT检查,多于治疗后3天~2周复查头部CT,并分析其不典型CT征象。结果:单纯表现为硬膜下小血肿20例,合并硬膜外血肿3例,并脑挫裂伤及蛛网膜下腔出血7例。所有硬膜下血肿均表现为邻近颅骨内缘模糊不清,呈“掩盖征”,局部颅骨“假性增厚”改变;血肿内缘与脑表面分界欠清,形态呈线弧状、细新月状改变,大部分病例颅内占位效应不明显。结论:颅骨内缘变模糊,呈“掩盖征”、局部颅骨“假性增厚征”是诊断不典型少量硬膜下血肿的重要CT征象。     

少见部位硬膜下血肿45例CT诊断分析

目的：探讨大脑镰及小脑幕硬膜下血肿的CT特征。方法：分析45例大脑镰、小脑幕硬膜下血肿CT表现。结果：大脑镰、小脑幕硬膜下血肿分别为29例、16例,CT均为高密度影,前者呈波浪状16例、均匀增宽条状5例、局限性梭形6例、前后尖端相对三角形2例;后者CT表现为片状6例、V形2例、“Y”形4例,圆环形3例、弧形1例。结论：大脑镰、小脑幕较颅板下硬膜下血肿少见,CT表现有一定特征性,少量出血易漏误诊。     

Traumatic epidural hematoma in a patient with severe schizencephaly

Schizencephaly is a rare congenital brain structural abnormality that is not clearly understood and has no specific treatment yet. Therefore, cases related to it should be added to the literature. This report aims to introduce a rare case of severe schizencephaly co‐occurring with post‐traumatic intracranial epidural hematoma.     

Spontaneous spinal epidural hematoma: a case report

A 59-year-old man presented to the emergency department (ED) the day after a minor motor vehicle crash for evaluation of bilateral shoulder pain. He underwent ED evaluation for his back pain two more times before it was found that he had a spontaneous spinal epidural hematoma (SSEH). On the third visit, the patient had waxing and waning neurologic symptoms including lower extremity weakness and urinary retention. The diagnosis was made by MRI, and the patient was successfully treated with cervical hemilaminectomy at the cervicothoracic junction for evacuation of the epidural hematoma 5 days after the onset of back pain.     

Spontaneous acute subdural hematoma and chronic epidural hematoma in a child with F XIII deficiency

Factor XIII (F XIII) deficiency is a rare autosomal recessive congenital disorder that can cause spontaneous subdural or epidural hematomas. Due to its low incidence, F XIII deficiency may well be under-diagnosed. A 7-year-old girl with no history of medical problems presented with progressive headache of 3 days. Cerebral computed tomography (CT) scans revealed a large right acute parietooccipital subdural hematoma with a significant midline shift. After an emergent parietooccipital craniotomy and evacuation of the subdural hematoma, a screening test for factor XIII was performed. The results of the test were abnormal. She had full recovery and was discharged with a follow-up treatment of monthly transfusion of fresh frozen plasma as the replacement and prophylactic therapy. Ten months later, she was referred to our center with headache after a minor head trauma. Her medical history revealed that she had not received fresh frozen plasma for the last 2 months. CT scan showed a chronic right parietal epidural hematoma beneath the craniotomy flap. The present case indicates that although its incidence is very rare, F XIII deficiency can cause acute or chronic subdural and epidural hematomas. Therefore, in acute or chronic subdural and epidural hematomas with no underlying cause, the presence of a potential F XIII deficiency should be suspected as a cause of hemorrhagic diathesis.     

急性硬脊膜外血肿的诊治

目的 研究急性硬脊膜外血肿的原因、临床表现、影像学特点及治疗方法。方法 对10a来经手术治疗的32例急性硬脊膜外血肿的病因、临床表现、MRI、DSA检查情况、手术治疗和随访结果进行分析。结果 32例病人中有26例直接手术清除血肿；6例先栓塞硬脊膜动静脉瘘（AVF）的供血动脉后，再手术清除血肿并切除瘘口。随访2－9a。神经系统恢复到正常情况11例；有轻度神经系统改变但生活可以自理15例；需他人帮助者4例；2例因血肿压迫时间，术后双下肢瘫痪及尿留渚留未改善；本组无死亡。结论 急性硬脊膜外血肿的早期诊断和治疗是提高疗效的关键。脊髓MRI检查是诊断急性硬脊膜外血肿的首选方法，清除血肿减轻其对脊髓的压迫是治疗本病的唯一有效方法、大的、高血流量的AVF术前栓塞供血动脉可减少术中出血。     

快速自溶的急性硬膜下血肿CT分析

目的探讨快速自溶的急性硬膜下血肿的临床及CT特征。方法收集急性期内完全或大部分溶解吸收的急性硬膜下血肿17例，72h内至少进行3次头颅CT平扫。结果17例急性硬膜下血肿在急性期完全或大部分溶解吸收，患者均经过保守治疗痊愈。结论快速自溶的急性硬膜下血肿经保守治疗预后较好，头颅CT追踪扫描对于本病的诊断及指导临床治疗具有重要的价值。     

Warfarin-related epidural hematoma: a case report

Spinal epidural hematomas are rare, with trauma being the most common cause. Spinal epidural hematomas caused by coagulation dysfunction are even rarer; however, long-term warfarin therapy increases the risk. The clinical manifestations of spinal epidural hematoma are neurological deficits below the corresponding spinal cord segment level. Magnetic resonance imaging (MRI) is the preferred method for diagnosis, and the main treatment for epidural hematoma with typical symptoms is urgent decompression of the lumbar spine. We describe an almost 80-year-old female patient who received long-term oral warfarin therapy for atrial fibrillation. She developed sudden onset waist pain, and 2 days later, she developed pain and weakness in both lower limbs. Computed tomography (CT) of the thoracolumbar spine showed no obvious hematoma. Eight days after admission, contrast-enhanced CT of the thoracolumbar spine showed intraspinal hematomas at T5–T8 and T12–L2 levels. We performed T3–T7 laminectomy, T5–T8 hematoma removal, and spinal dural repair. The clinical symptoms did not improve significantly, postoperatively. The low incidence of spinal epidural hematoma after anticoagulation treatment means this condition is not recognized timely, and it is misdiagnosed easily. Clinicians should consider this condition when patients treated with anticoagulants have neurological deficits below a spinal segmental plane.     

以生境成像技术提取血肿内亚区域平扫CT影像组学特征预测自发性颅内出血患者血肿增大

目的 观察以生境成像技术提取血肿内亚区域平扫CT(NCCT)影像组学特征预测自发性颅内出血(sICH)患者血肿增大(HE)的价值。方法 回顾性分析228例传统影像学无明显异常的sICH患者,根据HE与否分为HE组(n=99)与非HE(NHE)组(n=129);同时按8∶2比例划分训练集(n=182)与测试集(n=46)。比较组间临床、NCCT资料及实验室检查结果,以logistic回归分析筛选HE的影响因素。以生境成像技术将血肿ROI聚类划分为3个亚区,提取血肿整体(ROI_整体)和3个亚区域ROI(ROI_亚区1、ROI_亚区2、ROI_亚区3)的影像组学特征(ROI_亚区3位于血肿与脑组织临界区)并进行筛选;分别基于4个ROI构建4种预测模型,评估其预测HE效能。结果 HE组空腹血糖高于NHE组(t=2.047,P=0.041),但此非sICH HE的独立预测因素(P=0.070)。ROI_亚区3影像组学模型预测训练集和测试集sICH HE的曲线下面积分别为0.9...