CT平扫及双期增强扫描在预测高血压脑出血血肿扩大中的价值  

The value of conventional CT and dual-phase contrast enhanced CT scan in forecasting hematoma enlargement of the hypertensive intracerebral hemorrhage

作　　者：杜涛明[1] 秦菊[1] 丁杰 冉隆富[1] DU Taoming;QIN Ju;DING Jie;RAN Longfu(Department of CT Room,The Seventh People’s Hospital of Chengdu,Chengdu 610041,P.R.China)

机构地区：[1]四川省成都市第七人民医院CT室,四川成都610041

出　　处：《医学影像学杂志》2018年第6期877-879,883,共4页Journal of Medical Imaging

摘　　要：目的探讨头颅CT平扫及双期增强扫描在预测高血压脑出血患者脑内血肿扩大中的价值。方法回顾性分析47例高血压脑出血血肿扩大患者的初诊头颅CT平扫及增强扫描影像资料,观察初诊头颅CT检查脑内血肿发生部位、血肿形态及血肿密度,记录"点征"发生位置、多少,观察有无动脉瘤、血管畸形等。结果 47例脑内血肿扩大患者发生丘脑35例(74.5%),外囊区9例(19.1%),枕叶2例(4.2%),额叶1例(2.1%)。脑内血肿形态不规则44例(94%),血肿密度不均匀28例(59.5%),点征检出34例(72.3%),其中动脉期检出28例,静脉期检出5例,4例为多处点征;有3例(6.3%)血肿密度均匀、形态规则,未发现点征;血管畸形并出血1例,Willis环动脉瘤3例。结论通过对脑内血肿发生部位、形态、血肿密度及双期增强扫描点征的观察,可以有效预测脑内血肿扩大,对临床治疗提出指导性意见。Objective To investigate the value of conventional CT and dual-phase contrast enhanced CT scan in forecasting hematoma enlargement of the hypertensive intracerebral hemorrhage（ HICH）. Methods We retrospectively analyzed the imaging data of of 47 patients with hemotoma enlargement of HICH,who underwent the conventional CT and dual-phase contrast enhanced CT scan on head,observed the location,shape and density of the intracerebral haematoma,recorded location and the number of＂spot sign＂and,also,observed whether there were the aneurysm or cerebrovascular malformation（AVM）,and etc. Results In those 47 cases of hemotoma enlargement,35 cases occurred in hypothalamus（74. 5%）,9 cases in external capsules（19. 1%）,2 cases in occipital lobe（ 4. 2%）,and 1 case in frontal lobe（ 2. 1%）. 44 cases of intracerebral hematoma were irregular（94%）,28 cases were uneven of density（59. 5%）,34 cases exhibited the＂spot sign＂（72. 3%）,28 cases were detected in arterial phase,5 cases were detected in venous phase,and 4 cases had＂spot sign＂in several places. 3 cases of hematoma presented with homogeneous density,regular morphology,and no ＂spot sign＂. 1 case was AVM with hemorrhage and 3 cases were cerebral aneurysm in will＇s ring. Conclusion Observation of the location,shape and density of intracerebral haematoma,and the spot sign on dual-phase contrast enhanced CT scan could effectively forecast the enlargement of haematoma,thereby providing the guidance opinions for clinical treatment.

关 键 词：高血压脑出血 血肿扩大 点征 体层摄影术 X线计算机 

分 类 号：R814.4[医药卫生—影像医学与核医学] R541.7[医药卫生—放射医学]