继发于自发性颅内出血的神经源性肺水肿的影像学表现

目的:探讨自发性颅内出血并发神经源性肺水肿(NPE)的影像表现及与临床表现的相关性.方法:回顾性分析经临床证实的自发性颅内出血并发NPE的5个病例,均行CT平扫及胸部X线片检查,分析其表现及临床特征.结果:5例自发性颅内出血并发NPE中,脑干出血2例,小脑出血1例,大脑半球出血1例,自发性蛛网膜下腔出血1例.4例血肿均有破入临近脑室和/或蛛网膜下腔.5例患者的胸部X线片均示不同程度的肺水肿改变.治愈2例,死亡3例.结论:自发性颅内出血并发NPE患者的头颅CT均可见程度不同的颅内出血改变,其肺部表现为轻重不等的肺水肿征象,排除原发心、肺疾患及输液过快等因素,均应提示NPE,以免贻误抢救时机.

Imaging Manifestations of Intracranial Spontaneous Intracranial Hemorrhage Complicated with Neurogenic Pulmonary Edema

Objective:To explore the correlation between the imaging manifertations and clinical features of intracranial spontaneous hemorrhage(ISH)complicated with neurogenic pulmonary edema(NPE).Methods:Five patients compli-cated with NPE after the episode of ISH proved by clinical and imaging materials were retrospectively studied.In all the 5 cases,brain CT plain scans and X-ray chest films were performed.The CT images,X-ray chest films and relative clinical materials were retrospectively and respectively reviewed.Results:In the 5 ISH cases complicated with NPE,two hematomas were found in brain stem,one in cerebellar hemisphere,one in cerebral hemisphere and in one special case spontaneous subarachnoid hemorrhage(SAH)was shown.4 of the hematomas penetrated into the adjacent ventricles and/or subarachnoid cisterns were demonstrated.Various extents of pulmonary edema were revealed on X-ray chest films in all of the 5 cases.In 2 of the 5 cases,the NPE was cured and in the other 3 deaths resulted.Conclusion:Patients with intracranial spontaneous hemorrhage complicated with neurogenic pulmonary edema showed the signs of intracranial hematomas or SAH on cranial CT scans and the manifestations of various extents of pulmonary edema on X-ray chest images.In case that the pulmonary edema caused by cardiovascular and pulmonary diseases as well as rapid transfusion could be excluded,the diagnosis of NPE should be highly suggested,and thus,relative first-aided treatments for curing NPE would not be missed or delayed.