外伤性迟发性脑内血肿的早期CT表现

目的　研究外伤性迟发性脑内血肿的早期CT表现 ,评价这些表现对迟发性脑内血肿的预期诊断意义。方法　搜集CT复查证实的外伤性迟发性脑内血肿 31例 ,对其首次CT检查及复查的CT影像特点进行分析。按时间顺序抽取脑外伤后复查无脑内血肿病人 5 0例作为对照。统计处理2组观察结果。结果　 31例迟发性脑内血肿首次CT检查主要异常表现包括 :(1)限局性脑实质密度减低 ,灰白质分界不清 18例。 (2 )限局性蛛网膜下腔出血 2 4例。 (3)局部脑轻度占位效应 16例。 (4 )硬膜下血肿 9例。统计学显示与无迟发性脑内血肿差异有显著性意义 (χ2 =4 5× 10 -10 ,2 7 98,19 5 7,10 5 4,P值均 <0 0 1)。同时盲法测试结果显示 ,作者与盲法观察结果差异无显著性意义 (χ2 =1 0 3,0 34 ,2 81,P值均 >0 0 5 )。结论　脑外伤后首次行CT检查 ,出现局部脑实质密度减低 ,灰白质分界不清 ;局部蛛网膜下腔出血及脑占位效应 ,提示此部位可能出现迟发性脑内血肿 ,应及时做CT复查

Delayed traumatic hematomas of the brain: the early manifestations of CT

Objective To study the CT manifestations of delayed traumatic hematomas of the brain and evaluate their diagnostic significance in predicting the delayed traumatic brain hematoma. Methods The manifestations of initial CT studies and follow-up CT examinations of 31 delayed traumatic brain hematomas were analyzed. Another 50 CT studies of head trauma without delayed brain hematomas were included randomly as control. Results The abnormal findings of CT studies of the 31 delayed traumatic brain hematomas included: (1)Decreased density of the local brain parenchyma and disappeared difference between gray and white matter of the same area in 18 cases; (2)Local subarachnoid space hemorrhage in 24 cases; (3)Slight mass effect of local brain parenchyma in 16 cases. (4)Subdural hematoma in 9 cases. The locations of the abnormalities were roughly the same with the delayed hematoma except one local subarachnoid space hemorrhage, which was in the opposite of the delayed hematoma. The appearing rate of those abnormal findings in the control group was low and the difference was statistically significant. Conclusion The decrease of density of local brain parenchyma, the disappeared difference between the gray and white matter, local subarachnoid space hemorrhage, and local swollen of brain presented in the initial CT study of the patient with head trauma should be taken as indicators of delayed hemorrhage of the same area of brain, and it is necessary to do follow-up CT studies to exclude it.