小儿外伤性腔隙性脑梗塞的CT诊断

目的：探讨CT在外伤性腔隙性脑梗塞诊断中的价值及其特征。方法：对15例头颅外伤后，临床上主要表现为不同程度的偏瘫患者均为横断位CT扫描，。结果：外伤性腔隙脑梗塞好发于基底节内囊区，均位于豆状核、尾状核及内囊区，呈小片腔隙性低密度影，结论：CT扫描对外伤性脑梗塞的准确诊断、估计病变程度，预后有肯定价值。     

儿童外伤性腔隙性脑梗塞的CT诊断

目的　探讨CT对外伤性腔隙性脑梗塞的诊断价值及其特征。方法　对 2 6例颅脑外伤后临床主要表现为不同程度偏瘫患儿行横断CT扫描。结果　外伤性腔隙性脑梗塞好发于基底节内囊区 ,均位于豆状核、尾状核和内囊区 ,呈斑片腔隙性低密度影。结论　CT对外伤性腔隙性脑梗塞的诊断、评估病变的程度及其预后有重要价值     

小儿外伤性脑血管闭塞(附10例报告)

目的：研究小儿外伤性脑血管闭塞的临床与ＣＴ表现。探讨其形成的机理及ＣＴ诊断价值。方法：对１０例有明确颅外伤及伤后肢体偏瘫等体征的幼儿进行了ＣＴ扫描观察并记录。结果：２例正常，１例大面积脑梗塞、７例腔隙性脑梗塞（１例于丘脑、６例于内囊）。结论：外伤性腔隙性脑梗塞在幼儿中常见，而且大部分病变都发生在内囊（６∶１）。其产生的机理可能是脑外伤引起脑血管痉挛性闭塞所致脑缺血性坏死。ＣＴ扫描对其诊断的确立具有重要价值     

外伤性脑梗死的CT诊断(附39例分析)

目的：探讨螺旋CT在外伤性脑梗死诊断中的价值及其特征。方法：对39例头颈部外伤后临床主要表现为不同程度的偏瘫患者行横断面螺旋CT扫描，分析外伤性脑梗死的CT表现。结果：根据临床和CT表现分为两型：I型(21例)，外伤性腔隙性脑梗死，好发于基底节-内囊区，均位于豆状核、尾状核及内囊区，呈小片状腔隙性低密度区；Ⅱ型(18例)，外伤性大面积脑梗死，为脑叶梗死呈扇形低密度区，与大脑前中后供血动脉或颈内动脉分布一致，范围较大。结论：螺旋CT扫描检查对外伤性脑梗死的准确诊断、估计病变程度，分析两型脑梗死的不同发生机制，为临床诊断、治疗及判断预后提供重要信息。     

小儿外伤性腔隙性脑梗塞（附28例临床及CT分析）

报告２８例小儿外伤性脑梗塞，无发生于头部摔伤后（伤势不重），临床上主要表现为不同程度的偏瘫，梗塞灶均位于豆状，尾状核及内囊区，呈小片腔隙性。其中５７％的患儿双侧豆状核区有细小点状钙化。作者讨论了这种脑梗塞的发生机制、临床、ＣＴ特征以及预后。     

CUBE-T_2WI序列在显示腔隙性脑梗塞中的应用

目的探讨应用CUBE-T_2WI序列诊断腔隙性脑梗塞的优势。方法采用1.5T磁共振仪分别对35例腔隙性脑梗塞患者行头颅MRI CUBE-T_2WI序列及T2WI序列扫描,分析不同扫描序列所得图像,评价CUBE-T_2WI序列对腔隙性脑梗塞的诊断价值。结果对于35例腔隙性脑梗塞患者,CUBE-T2WI序列显示378个腔隙灶,其中顶叶79个,额叶147个,丘脑13个,内囊36个,基底节68个,脑干18个,小脑17个。T_2WI序列显示273个腔隙灶其中顶叶58个,额叶112个,丘脑9个,内囊28个,基底节43个,脑干13个,小脑10个。结论 CUBE-T_2WI序列较T_2WI序列对腔隙性脑梗塞的诊断更清晰、准确,提高了腔隙性脑梗塞小病灶的检出率。     

小儿外伤性基底节区腔隙性脑梗塞的CT与临床

目的：研究小儿外伤性基底节区腔隙性脑梗塞的临床与CT表现。探计其形成的机理、CT诊断价值及预后。方法：对10例有明确颅外伤史，临床上主要表现为偏瘫、癫痫等症状的小儿均作头颅CT平扫。结果：10制均为单发腔隙性脑梗塞，其中3例双侧基底节区有小钙化灶。结论：小儿外伤性基底节区腔隙性脑梗塞产生的机理可能是脑外伤引起脑血管痉挛性闭塞所致脑缺血性坏死。CT扫描对其诊断的确立和估计预后有重要价值。     

螺旋CT平扫在腔隙性脑梗塞诊断中的应用价值

目的：探讨螺旋CT平扫在腔隙性脑梗塞诊断中的应用价值。方法：回顾性分析本院螺旋CT扫描,分别采用5 mm及10 mm不同层厚观察临床及其它检查诊断为腔隙性脑梗塞病例200例。结果：5 mm层厚扫描100例,诊断为腔隙性脑梗塞95例,共发现病灶120个;10 mm层厚扫描100例,诊断腔隙性脑梗塞50例,发现病灶51个。结论：螺旋CT、5 mm以下层厚扫描是诊断腔隙性脑梗塞的可靠方法。     

外伤性脑梗塞的CT诊断

目的：探讨外伤性脑梗塞的分型与ＣＴ表现。方法：分析３５例外伤性脑梗塞的临床与ＣＴ表现。结果：根据其临床和ＣＴ表现分为二型：Ⅰ型（２１例）,轻微外伤型;Ⅱ型（１４例）,严重外伤型。Ⅰ型见于小儿,特别是婴儿,外伤轻微,ＣＴ表现为基底节区腔隙性梗塞灶,８１％（１７／２１）双侧豆状核点状钙化灶。Ⅱ型多见于成人,小儿少见,有严重的颅脑损伤,ＣＴ表现为基底节区或／和脑叶梗塞及颅脑损伤的征象,如脑内水肿,挫伤和颅内血肿等。结论：ＣＴ对外伤性脑梗塞有很大的诊断价值,两型可能有不同的发生机制,Ⅰ型主要是潜在性血管病变及血管痉挛所致,Ⅱ型主要与血管的损伤和受压有关     

CUBE-T_2WI在腔隙性脑梗死诊断中的应用

目的 :探讨应用CUBE-T2WI序列诊断腔隙性脑梗死的优势。方法:采用1.5 T MRI分别对35例腔隙性脑梗死患者行头颅MRI CUBE-T2WI列序及T2WI序列扫描,分析不同扫描序列所得图像,评价CUBE-T2WI序列对腔隙性脑梗死的诊断价值。结果:35例中,CUBE-T2WI序列显示378个腔隙灶,其中顶叶79个,额叶147个,丘脑13个,内囊36个,基底节68个,脑干18个,小脑17个。T2WI序列显示273个腔隙灶,其中顶叶58个,额叶112个,丘脑9个,内囊28个,基底节43个,脑干13个,小脑10个。结论:CUBE-T2WI序列较T2WI序列对腔隙性脑梗死的诊断更清晰、准确,提高了腔隙性脑梗死小病灶的检出率。     

老年高血压并发腔隙性脑梗死的诊断与处理

目的总结老年高血压并发腔隙性脑梗死的诊断与急诊处理经验。方法对疑诊老年高血压并发腔隙性脑梗死的12例患者,及时行头颅CT或MR I检查;确诊后及时进行降血压、增加脑血流、改善脑循环、保护脑神经、处理并发症等处理。结果治愈6例,显效4例,好转2例。结论诊断老年高血压并发腔隙性脑梗死应根据临床表现和影像学改变;治疗要及时进行上述综合处理。     

24 小时内缺血性脑梗塞的CT 研究

通过回顾性分析病程在２４小时因性脑塞患者的ＣＴ片,对其早期ＣＴ征象进行评价,以提高对该病的早期诊断水平。方法回顾性分析经临床确诊的２５０例２４小时内脑梗塞及１００例正常人的ＣＴ表现,评价致密动脉征,豆状核征,脑岛带征,占位征,低密度灶,皮质征等ＣＴ表现。     

MRI评估糖尿病患者的腔隙性脑梗死

目的：应用ＭＲＩ评估糖尿病患者的腔隙性脑梗死。材料和方法：对６０例糖尿病患者行ＭＲＩ检查,统计和分析糖尿病患者的腔隙性脑梗死的数目、分布和分期。结果：ＭＲＩ共发现１２０７个腔隙性脑梗死灶,多发性病灶占全部病灶的９９．３％,大脑半球病灶占全部病灶的８４．３４％,５０岁－至８０岁－年龄组为高发年龄组,而慢性病灶极为少见。结论：ＭＲＩ是目前显示腔隙性脑梗死的最可靠方法。     

Prediction of neurologic deterioration in patients with lacunar infarction in the territory of the lenticulostriate artery using perfusion CT

BACKGROUND AND PURPOSE: A significant proportion of patients with lacunar infarctions experience neurologic deterioration after onset. However, no clinical examination has been established for prediction of the progress of symptoms. To determine the hemodynamic predictors of such progression, we performed perfusion CT to quantitatively assess cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) of patients with lacunar infarctions in the territory of the lenticulostriate artery. METHODS: We performed MR imaging and perfusion CT of 26 patients with lacunar infarction within 24 hr after onset. On the CBF map on perfusion CT scans, a round small region of interest was set at the region, with decreased CBF in the territory of the lenticulostriate artery (region of interest 1). Another region of interest was set in the mirror position to region of interest 1 in the contralateral hemisphere (region of interest 2). Using these two regions of interest, CBF, CBV, and MTT were measured. All patients underwent neurologic and MR imaging follow-up while receiving equivalent medical treatment. RESULTS: Neurologic deterioration after onset was shown in 13 patients (progress group), whereas no neurologic deterioration was shown in the other 13 patients (control group). In the progress group, lacunar infarctions were enlarged on follow-up MR images. The ratio of region of interest 1/region of interest 2 showed significantly lower CBF and higher MTT in the progress group than in the control group. CONCLUSIONS: These results suggest that progressive lacunar infarction in the territory of the lenticulostriate artery could be predicted with a higher MTT ratio (>1.26) and a lower CBF ratio (<0.76) on perfusion CT scans obtained within 24 hr after onset.     

超急性期脑梗塞的常规CT检查（附66例分析）

目的：探讨常规CT对超急性期脑梗塞的诊断价值。方法：回顾性分析我院资料较完整的66例超急性期脑梗塞的临床表现和CT征象。结果：早期常规CT平扫。显示大脑中动脉高密度征8例;脑实质低密度征。包括大脑凸面11例,豆状核17例,脑岛10例;另有局部肿胀征14例。结论：常规CT对超急性期脑梗塞的诊断。具有一定价值。     

系统性红斑狼疮脑病的CT诊断(附8例报告)

目的评价CT对系统性红斑狼疮脑病的诊断价值。方法对经临床证实的10例系统性红斑狼疮脑病的CT表现作回顾性分析。结果8例CT表现异常、其中4例表现为双额叶、3例表现为双顶、枕叶弥漫性低密度影，以累及脑白质为主，并累及部分脑皮质及基底节区，分布对称；另1例表现为多发性腔隙性脑梗塞。结论CT对脑部病变的显示有较高的敏感性，对系统性红斑狼疮脑病的诊断、治疗有一定的指导意义，但该病CT表现无特异性，必须密切结合临床方能做出正确诊断。     

Relationship between extent of brain hypoperfused area and functional outcome in patients with a small subcortical infarction: evaluation with X-ray CT, 123I-IMP cerebral perfusion SPECT and cerebral angiography]

We performed 123I-IMP single photon emission computed tomography (SPECT) in 43 patients who had a small infarction (less than 2 cm) in subcortical area and who were less than 1 month after onset of stroke. Hypoperfused area of brain was qualitatively assessed and was compared with functional outcome at 6-month after the stroke and the cerebral angiogram. Functional outcome was poorer in patients who had wider hypoperfused area in brain (chi 2 = 29.3; p less than 0.001). The extent of brain hypoperfused area showed a positive correlation with the degree of stenosis in the extracranial and/or intracranial arteries (r = 0.61; p less than 0.01). In patients who had no angiographic abnormality, the extent and the location of the hypoperfused area were equivalent to that of the low density area in CT. Thus 123I-IMP SPECT in patients with a small infarction may discriminate lacunar infarction from embolic or hemodynamic infarction, which was caused by vascular lesions of major cerebral arteries, in subcortical area. Our study suggests that functional outcome is better in lacunar infarction than embolic or hemodynamic infarction in subcortical area.     

成人外伤性脑梗死的CT诊断

目的 探讨成人外伤性脑梗死的影像特点.方法 分析30例成人外伤性脑梗死的临床与CT资料.结果 脑叶梗死17例,基底节-内囊区梗死13例,伴蛛网膜下腔出血15例,硬膜下血肿9例,硬膜外血肿3例,脑内血肿3例,脑疝5例,出血性脑梗死2例.结论 CT发现成人外伤性脑梗死的最佳时间是外伤后24 h～6 d,梗死多伴有颅脑损伤的其他CT表现,临床结合动态CT观察是诊断成人外伤性脑梗死的有效方法.