慢性硬膜下血肿MRI表现和不同手术方法与其复发的关系

目的 探讨慢性硬膜下血肿(CSDH)术前MRI表现和不同手术方法与其复发的关系。方法 回顾分析了126例(共149个血肿)CSDH术前MRI资料,依血肿在MRI T_1 WI的表现分为高信号组(62例)和非高信号组(64例);又依治疗方法的不同,分为单纯钻孔冲洗治疗组和钻孔冲洗 闭式引流治疗组,分别比较其复发率。结果 高信号组和非高信号组复发率分别为4％和17.6％,两者相较,相差显著(P<0.05);钻孔引流和单纯钻孔复发率分别为6.1％和16.4％,两者相较,亦相差显著(P<0.05)。结论 CSDH术前MRI表现可以预测其复发率,采用闭式引流可以明显地减少其复发率。

Relationship between Recurrence and Preoperative MRI Findings or Different Operative Method in Patients of Chronic Subdural Hematoma

Objective To study the relationship between the recurrence of chronic subdural hematoma (CSDH) and its preoperative MRI findings or different surgical procedure. Methods The data of the preoperative MRI were analyzed retrospectively in the 126 patients with CSDH, who were divided into the high-and nonhigh-intense signal groups on the basis of the appearance on T1 -weighted MR images, and into simple holing irrigation (SHI) and holing irrigation with closed system drainage (HICSD) groups according to the different treatment method. The recurrence rate of CSDH was compared respectively. Results The recurrence rate (4%) in the high-intense signal group was significantly lower than that (17.6%) in the nonhigh-intense signal group (P<0.05). There was significant difference in the recurrence rate between SHI (16.4%) and HICSD (6.1%) groups (P<0.05). Conclusion MRI is helpful to predicting CSDH recurrence. The closed system drainage can significantly reduce the recurrence of CSDH regardless of MR findings in the patients with CSDH.