颅骨陷窝症CT、MRI诊断探讨

目的探讨新生儿颅骨陷窝在64排螺旋CT和1.5T MR的影像学表现及特点。方法用GE optima 64排螺旋CT对17例颅骨陷窝症患儿行头颅CT横轴位扫描、多平面重建(multiple planar reconstruction,MPR)和表面遮盖法重建(surface shaded display,SSD),检查前后2天内行GE Signa MR头颅扫描,并且均于6个月后CT随访,其中6例患儿分别于6个月及1年后随访,对头颅CT影像表现进行分析。结果本组17例头颅CT横轴位及重建冠状位、矢状位示颅骨有较多的卵圆形骨密度减低区,周围局部颅骨密度增高,主要累及内板、板障,外板骨质变薄,病变部位位于顶骨、枕骨,其中2例尚累及额骨,3例累及颞骨。并有颅缝增宽、轻度脑积水及脑膜脑膨出各1例。SSD示颅骨遍布大小不等的类圆形骨密度减低区,呈蜂窝状。结论本病的螺旋CT影像学表现有特征性,结合MR颅脑影像表现及临床表现,可做出诊断及鉴别诊断。

The Investigation of the Diagnosis in the Craniolacunia with CT and MR

Objective To investigate the CT and MRI characteristics of neonatal craniolacunia. Methods 17 neonates with craniolacunia underwent skull axial CT scan, and image post-processing such as multiple planar reconstruction （MPR）, surface shaded display （SSD） were applied. The MR scan were arranged synchronistically with GE Signa. A total of 21 neonates accept the follow-up CT examination 6 months later, among them 6 cases accept follow-up CT examination 1 year later in addition. The imaging findings were analyzed. Results This group of 17 cases of skull CT transverse and coronal, sagittal reconstruction display the skull has many ovoid bone mineral density reduced areas, bone density around is increased. The inner plate and diploe were involve mainly, outer plate become thinner than the normal, lesions located in the parietal, occipital bone, with frontal bone involvement of 2 cases and temporal bone of 3 cases. One case of cranial suture broadening, mild hydrocephalus and meningoencephalocele was complicated. Varied sizes of round bone density reduced areas were distributed all over the skull in SSD, like honeycomb. Conclusion The CT manifestation of neonate craniolacuni is characteristic, we can make diagnosis and differential diagnosis by combining with MRI and clinical manifestation.