CT平扫在小儿颅脑外伤性硬膜外血肿早期诊断及术后短期复查中的临床运用价值分析  

The Clinical Application Value Analysis of CT Plain Scan in Early Diagnosis of Traumatic Epidural Hematoma in Children and Short-term Postoperative Review

作　　者：魏小兵[1] 黄喆[1] 董宇为[1] WEI Xiao-bing;HUANG Zhe;Dong Yu-wei(Department of Neurosurgery,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi Province,China)

机构地区：[1]陕西省汉中市中心医院神经外科二病区

出　　处：《中国CT和MRI杂志》2019年第11期23-25,共3页Chinese Journal of CT and MRI

基　　金：陕西省科学技术基金资助项目(961202y0646)

摘　　要：目的旨在探讨CT平扫在小儿颅脑外伤性硬膜外血肿早期诊断及术后短期复查中的临床运用价值。方法选取我院2016年10月-2018年1月收治的颅脑外伤性硬膜外血肿患儿51例,总结颅脑外伤性硬膜外血肿在CT平扫中的图像表现特征,计算CT平扫对硬膜外血肿的诊断符合率。51例患儿病例在手术后30天内复查CT2次以上,分析手术前后CT平扫图像变化情况。结果51例患儿CT平扫图像中,血肿部位均呈现为不同密度的阴影,阴影主要为“双凸状”或“梭形”,少数患儿在高密度影内存在片状低密度区,呈现“egg征”血肿体积<30mL者21例,≥30mL者30例,43例患儿血肿区域边界较为清晰,9例患儿患儿血肿邻近脑皮质受压塌陷,中线结构偏移,脑室脑池变形,存在占位效应改变,颅压增高症状较明显,合并颅骨骨折者29例。对照手术结果,CT平扫对颅脑外伤性硬膜外血肿的诊断符合率为96.07%。对比手术前CT图像,术后短期复查CT平扫图像可直观显示混杂密度影范围、密度、骨线变化情况。结论CT平扫对小儿颅脑外伤性硬膜外血肿早期诊断符合率高,可有效显示血肿范围、密度及毗邻脑组织,可密切观察术后病情变化情况,以保障临床治疗效果。Objective To explore the clinical application value of CT plain scanning in the early diagnosis and short-term postoperative review of traumatic epidural hematoma in children.Methods A total of 51 cases of children with traumatic epidural hematoma admitted and treated in our hospital from October 2016 to January 2018 were selected to summarize the image features of traumatic epidural hematoma in CT scanning and calculate the diagnostic coincidence rate of CT scanning for epidural hematoma.In 51 cases,CT was reviewed more than 2 times within 30 days after surgery,and the changes of CT images before and after surgery were analyzed.Results In the CT scan images of 51 children,all the hematoma sites showed shadows of different densities.The shadows were mainly"biconvular"or"fusiform",and a few children had flaky low density areas in the high-density shadows.There were 21 cases with"egg sign"hematoma volume<30mL,30 cases with more than 30mL,43 cases with clear hematoma region boundary,9 cases with hematoma adjacent to cerebral cortex compression collapse,midline structure deviation,ventriculo-cistern deformation,space-occupying effect change,increased cranial pressure symptoms,29 cases with skull fracture.The diagnostic coincidence rate of CT non-enhanced scan for traumatic epidural hematoma was 96.07%.Compared with the CT images before surgery,the CT plain scan images after short-term reexamination can directly show the variation of mixed density shadow range,density and bone line.Conclusion CT scanning has high coincidence rate in early diagnosis of traumatic epidural hematoma in children,which can effectively show the range,density and adjacent brain tissue of hematoma,and can closely observe the changes of postoperative condition to guarantee the clinical treatment effect.

关 键 词：CT平扫 颅脑外伤性硬膜外血肿 早期诊断 术后短期复查 临床运用价值 

分 类 号：R445.3[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]