颅脑损伤后精神障碍的影像学表现分析

目的分析颅脑损伤后精神障碍的影像学表现。方法选取2014年8月至2016年9月我院收治的颅脑损伤后精神障碍患者63例为研究对象,均行CT及MRI检查,分析CT及MRI对颅脑损伤异常部位的检出率及影像特点,对比CT及MRI的诊断灵敏度、特异度、准确度,同时评价Rotterdam CT评分在判断颅脑损伤预后中的价值。结果 MRI共检出116处部位异常,CT检查显示87处部位异常,MRI对异常部位检出率80.0%高于CT60.0%(P0.05);CT检查显示中型颅脑损伤患者脑严重挫裂伤及脑水肿肿胀,见外侧裂及脑池积血、创伤性蛛网膜下腔出血,重型颅脑损伤患者右侧额颞少量硬膜下血肿及左侧脑室后角积血,MRI显示颅板骨质断裂者在T2WI线处见信号影,头皮损伤检查中显示等T1、长T2信号影,脑部受力同侧或对侧发生挫伤者MRI显示皮质下片状异常信号影,T1WI见低信号影,T2WI为高信号影,信号均匀;CT诊断颅脑损伤后精神障碍的灵敏度、特异度与MRI比较无显著差异(P0.05),但其准确度61.90%低于MRI 79.37%(P0.05);Rotterdam CT评分为轻、中、重型患者的死亡、中残及重残人数差异较大,具有统计学意义(P0.05)。结论 CT及MRI对颅脑损伤后精神障碍均有一定诊断价值,且MRI在准确性方面占优势,Rotterdam CT评分可用于预后评估,值得在临床推广应用。

Imaging Findings of Mental Disorders after Craniocerebral Injury

Objective To analyze the imaging findings of mental disorders after craniocerebral injury.Methods A total of 63 patients with mental disorders after craniocerebral injury who were admitted to our hospital between August 2014 and September 2016 were selected as the study subjects. All patients were examined by CT and MRI. The detection rate and imaging findings of CT and MRI in abnormal sites of craniocerebral injury were analyzed. The diagnostic sensitivities, specificities and accuracies of CT and MRI were compared, and the value of Rotterdam CT score in evaluating the prognosis of craniocerebral injury was evaluated.Results MRI detected a total of 116 abnormal parts and CT detected 87 abnormal parts. The detection rate of MRI (80.0%) was higher than that of CT (60.0%) (P<0.05). CT examination showed severe contusion and laceration, brain edema and brain swelling, lateral fissure and brain cistern hematocele and traumatic subarachnoid hemorrhage in patients with moderate craniocerebral injury, little right frontotemporal subdural hematoma and left ventricle posterior horn hematocele in patients with severe craniocerebral injury. MRI showed signal on T2WI in patients with cranial plate fractures, equal T1 and long T2 signal in scalp injury. MRI showed subcortical patchy abnormal signals in patients with brain stress ipsilateral or contralateral contusion, low signal on T1WI, high signal on T2WI and homogeneous signal. The sensitivity and specificity showed no significant differences between CT and MRI in the diagnosis of mental disorders after craniocerebral injury (P>0.05). The accuracy was lower than that of MRI (61.90% vs 79.37%) (P<0.05). Rotterdam CT score showed significant differences between patients with mild, medium and severe disease (P<0.05). Conclusion Both CT and MRI are of certain value in the diagnosis of mental disorders after craniocerebral injury, and the accuracy of MRI is relatively higher. Rotterdam CT score can be used to assess the prognosis.