脑出血微创置管引流术致骨屑颅内残留的影像学观测及临床意义  

Imaging Observation and Clinical Significance of Intracranial Residual Caused by Minimally Invasive Catheter Drainage of Cerebral Haemorrhage

作　　者：王旭辉 赵洪全 陈杨 WANG Xu-hui;ZHAO Hong-quan;CHEN Yang(Department of Radiology,Yantai Yeda Hospital,Yanta 264000,Shandong Province,China)

机构地区：[1]烟台业达医院影像科,山东烟台264000

出　　处：《罕少疾病杂志》2024年第4期14-16,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的回顾总结脑出血微创置管引流术后骨碎屑进入颅内的影像学表现及临床意义。方法收集烟台业达医院2015年1月-2022年4月间,临床资料完整的脑出血微创置管引流术病人105例,PACS存储的CT原始图像结合MPR重建影像,观测各穿刺部位碎屑入颅的发生率,导管入颅深度,碎屑的分布及入颅深度。结果105例病人,共174个颅孔行引流术,各常见穿刺部位比较,引流管深度差别无统计学意义(P>0.05);共有80例(76.2%),122个颅孔(70.1%)见大小不等、多少不一的高密度骨屑进入颅内,深度3-73mm,平均20.3±15.0mm。骨屑主要分布在引流管周围,由浅至深逐渐减少,其中6例脑室引流者骨屑深达脑室边缘或进入脑室。经软件SPSS 22.1统计分析:双侧颅骨孔间比较,双侧额骨、颞骨间对应比较,同侧额骨与颞骨间分别比较,碎屑入颅阳性率、骨屑入颅深度差别均无统计学意义(P>0.05)。结论脑出血微创置管引流术可能导致骨屑进入颅内,不同穿刺引流部位影像表现类似,其临床预后差别不明显。Objective The imaging findings and clinical significance of bone debris entry after minimally invasive catheterization and drainage of intracerebral hemorrhage were reviewed Methods According to the Yantai Yeda Hospital,From January 2015 to April 2022,105 patients with cerebral hemorrhage underwent minimally invasive catheterization and drainage with complete clinical data in our hospital.The original CT images stored in PACS combined with MPR reconstruction images were used to observe the depth of catheter insertion at each puncture site,the incidence of debris insertion,the distribution of debris and the depth of insertion.Results A total of 174 cranial foramen were drained in 105 patients.There was no significant difference in the depth of drainage tube between the common puncture sites(P>0.05).There were 80 cases(76.2%),122 cranial foramen(70.1%)showed different sizes of high-density bone debris into the intracranial,the depth was 3-73mm,the average 20.3±15.0mm.The bone debris was mainly distributed around the drainage tube and gradually decreased from shallow to deep.In 6 cases of ventricular drainage,the bone debris reached the ventricular edge or entered the ventricle.Statistical analysis by software SPSS22.1 showed that there was no significant difference in the positive rate of detrital penetration and the depth of bone debris penetration between bilateral cranial pores,bilateral frontal bone and temporal bone,and ipsilateral frontal bone and temporal bone respectively(P>0.05).Conclusions Minimally invasive catheterization and drainage of cerebral hemorrhage may cause bone debris to enter the brain.The imaging manifestations of different puncture and drainage sites are similar,the difference in its clinical prognosis is not obvious.

关 键 词：脑出血 微创手术 骨屑移位 CT 影像诊断 

分 类 号：R651.1[医药卫生—外科学] R445.3[医药卫生—临床医学]