难治性精神分裂症CT表现及多靶点联合毁损术后CT征象分析  

CT Manifestions in Treatment-Resistant Schizophrenia and in that Post-multi-target Lesion Surgery for Impairment

作　　者：袁新平[1] 王一芳[2] 徐华强[1] 王健[1] 

机构地区：[1]解放军第454医院CT室,南京210002 [2]解放军第454医院神经外科,南京210002

出　　处：《放射学实践》2007年第7期683-686,共4页Radiologic Practice

摘　　要：目的：探讨难治性精神分裂症（TRS）的CT表现和多靶点联合毁损术后CT影像特点。方法：对464例TRS患者术前CT和56例TRS患者术后CT表现进行回顾性分析，并测量毁损灶体积。56例TRS患者术后疗效评定为Ⅰ-Ⅱ级37例，Ⅲ-Ⅳ级19例；Ⅰ-Ⅱ级患者术后2-10d行CT扫描25例、40-90d16例，19例Ⅲ-Ⅳ级患者术后6-7个月行CT扫描。结果：TRS患者的主要CT表现为脑萎缩，发生率为36.2%（168/464），其中皮质型脑萎缩占25%（116/464）。术后2-10d，毁损灶呈类圆形和柱形者为93.3%（140/150），片状不规则形为6.7%（10/150）；术后40-90d，病灶呈类圆形和柱形为66.2%（65/96），片状不规则形为33.8%（31/96）。结论：术前CT扫描可作为筛选TRS手术患者的一种手段，脑萎缩患者选择手术治疗应慎重；术后不同时期CT扫描可客观评价手术疗效，为手术方案改进、并发症的预防和处理提供参考。Objective：To study the CT manifestations of treatment-resistant schizophrenia （TRS） as well as that after surgery for impairment of multi-target lesions. Methods：The CT manifestions of 464 patients with TRS and that of 56 patients after surgery for impairment of multi-target lesions were retrospectively analyzed, the volume of damaged lesion foci were measured. The therapeutic effect of 56 patients were evaluated as grade Ⅰ - Ⅱ in 37 cases,grade Ⅲ - Ⅳ in 19 cases. 25 times-patients of CT scan were performed 2-10 days after operation in grade Ⅰ - Ⅱ patients,and 16 times-patients of CT scan 40-90 days after operation. 19 grade Ⅲ -Ⅳ patients had CT scan 6-7 months after operation. Results：CT manifestions in TRS were mainly brain atrophy, the incidence rate was 36.2 % （168/464 patients）, with the cortical atrophy accounted for 25 % （116/464 patients）. At 2 - 10 days after operation, the damaged lesion showed oval and cylindrical in shape in 140/150 foci （93.30/00）,patchy in 10/150 foci （6.7%）. At 40-90 days after operation,there were oval and cylindrical shape in 65/96 foci （66.20%）,patchy in 31/96 foci （33.8%）. Deviated targets were showed in 45/76 foci in 19 grade Ⅲ- Ⅳ patients. The volume of damaged lesions shrunk in that of amygdala and forelimb within internal capsule,the therapeutic effect showed significant difference between 19 grade Ⅲ- Ⅳ and 16 grade Ⅰ - Ⅱ cases. Conclusion：CT scanning can be used as the modality of choice to select TRS patients whether surgery for impairment should be undertaken, a prudent policy should be adopted for patients with brain atrophy. The therapeutic effect can be objectively evaluated by CT scanning in various period after operation, provides useful reference for the improvement of surgery planning, prevention and treatment of surgical complication.

关 键 词：体层摄影术 X线计算机 立体定向术 精神分裂症 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]