缺血性脑梗死与出血性脑梗死的CT鉴别诊断

目的讨论缺血性脑梗死(ICI)和出血性脑梗死(HCI)的CT鉴别诊断。方法21例ICI和11例HCI于临床症状出现后3h～29d内均经头颅CT平扫,对两组病人的CT表现进行了对比分析。结果在21例ICI患者的CT像上,18例表现为大片状低密度影内边缘清楚略高密度脑回状影“脑回征”和大片状低密度影内淡片状高密度影“浮云征”,3例表现为大片状低密度影内团块状高密度影“假肿瘤征”,而在11例HCI患者的CT像上,7例表现为大片状低密度影内不规则斑片状高密度影,4例表现为大片状低密度影内边缘模糊的血肿影。结论ICI与HCI具有不同的CT征象,因此,CT扫描是鉴别这两种疾病的关键技术。

Differential diagnosis between ischemic - and hemorrhagic cerebral infarction with CT

Objective To discuss the differential diagnosis of ischemic cerebral infarction(ICI)versus hemorrhagic cerebral infarction(HCI)with computed tomography(CT).Methods Thirty-two patients who comprised 21 ICI and 11 HCI underwent CT plain scans of the head within 3 hours-29 days after onset of clinical symptoms. CT findings in the two groups patients were comparatively analyzed.Results on CT images of 21 ICI,slighfly hyperdense gyrus signs and cloud rack signs were found in 18,hyperdense pseudotumor signs in cerebral malacia zone were found in 3,while on CT images of 11 HCI,irregular patchy shadows with hyperdensity in infarction foci were found in 7,hematomas in infarction foci were found in 4 cases. Conclusion ICI and HCI have different CT signs and therefore CT scanning is a critical technique for differentiate these two diseases.