颅脑损伤后CT影像特点及神经内分泌变化研究  

Research on the CT imaging features and the neuroendocrine changes post craniocerebral injury

作　　者：吴泽健 许欢[2] 徐蓉[1] 邱炳辉[3] 蔡裕兴[1] WU Ze-jian;XU Huan;XU Rong(Department of Radiology,Nanfang Hospital,Southern Medical University,Guangzhou 515100,China;不详)

机构地区：[1]南方医科大学南方医院放射科,广东广州515100 [2]广州市疾病预防控制中心慢性非传染性疾病预防控制部,广东广州510440 [3]南方医科大学南方医院神经外科,广东广州510515

出　　处：《中国医学装备》2020年第5期91-94,共4页China Medical Equipment

基　　金：广东省科技计划(2013B021800304)“颅脑损伤后神经内分泌变化规律研究”。

摘　　要：目的:观察患者颅脑损伤后的CT影像特点,分析其神经内分泌变化情况。方法:选取医院收治的94例颅脑损伤患者,按照入院时的格拉斯哥昏迷指数(GCS)评分,将其分为轻型组(25例)、中型组(36例)和重型组(33例),3组患者均行头颅CT扫描,分析患者CT影像特点与颅内压(ICP)的相关性;另选取同期体检的25名健康体检者纳入健康对照组,比较4组神经内分泌皮质醇(COR)水平,并分析COR与颅脑损伤严重程度的相关性。结果:颅脑损伤患者不同颅脑外伤鹿特丹CT(Rotterdam CT)评分、基底池的ICP比较,差异有统计学意义(F=95.521,F=103.815;P<0.05);不同脑室受压和中线移位患者的ICP比较,差异有统计学意义(t=9.400,t=6.849;P<0.05);基底池评分、脑室受压、中线移位、RotterdamCT评分与ICP具有相关性(r=-0.835,r=-0.572,r=0.465,r=0.983;P<0.05),RotterdamCT评分相关性最强,其次是基底池情况、脑室受压及中线移位;重型组COR水平高于中型组,重型组和中型组均高于轻型组,差异有统计学意义(t重中型组=8.243,t重轻型组=17.101,t中轻型组=11.525;P<0.05);健康对照组与轻型组COR水平比较差异无统计学意义;COR与颅脑损伤严重程度呈显著正相关(r=0.317,P<0.05)。结论:临床评估颅脑损伤后ICP时,RotterdamCT评分优于其他单个CT影像特点,颅脑损伤越严重,COR水平升高幅度越明显。Objective:To observe the computed tomography(CT)imaging features of patients post craniocerebral injury,and analyze neuroendocrine changes of them.Methods:94 patients with craniocerebral injury were selected from hospital and they were divided into mild group(25 cases),moderate group(36 cases)and severe group(33 cases)according to the Glasgow Coma Scale(GCS)score at admission.All subjects underwent brain CT scan.The correlation of CT imaging features and intracranial pressure(ICP)of patients was analyzed.25 healthy subjects who were confirmed by physical examination in the same period were divided into healthy control group.The neuroendocrine cortisol(COR)levels among 4 groups were compared,and the correlation of COR and the severity of craniocerebral injury was further analyzed.Results:The differences of Rotterdam CT scores and ICP of basal cistern of patients with craniocerebral injury among different severities of injury were significant(F=95.521,F=103.815,P<0.05).The difference of ICP among patients with different ventricular compression and midline shift was significant(t=9.400,t=6.849,P<0.05).Basal cistern scores,ventricular compression,midline shift and Rotterdam CT scores were correlated with ICP(r=-0.835,r=-0.572,r=0.465,r=0.983,P<0.05).And the correlation of Rotterdam CT scores and ICP was the strongest,and followed by the condition of basal cistern,ventricular compression and midline shift.COR level of severe group was significantly higher than that of moderate group,and those both severe group and moderate group were significantly higher than that of mild group(tsevere and moderate group=8.243,tsevere and mild group=17.101,tmoderate and mild group=11.525,P<0.05),respectively.There was no significant difference in COR level between healthy control group and mild group.There was significant positive correlation between COR and severity of craniocerebral injury(r=0.317,P<0.05).Conclusion:In clinical assessment of ICP post craniocerebral injury,Rotterdam CT score is better than other single CT imaging fea

关 键 词：颅脑损伤 电子计算机断层扫描(CT) 影像特点 神经内分泌 

分 类 号：R816.1[医药卫生—放射医学]