摘要
目的分析CT对脑肿瘤卒中与脑出血的诊断及鉴别诊断价值,以期对临床脑肿瘤卒中的诊疗提供借鉴。方法我们收集2012-04—2014-06入住我院经病理或临床证实的脑肿瘤卒中40例为研究对象,所有患者均发病12h内行CT扫描和灌注成像,同时入选年龄性别相同的高血压脑出血患者40例为对照组,分析CT对脑肿瘤卒中与脑出血的诊断,及2组的出血量情况、脑灌注参数如脑血流量(CBF)、脑血容量(CBV)参数、毛细血管表面通透性(PS)等灌注参数。结果脑肿瘤卒中明确诊断22例,误诊为单纯性脑出血18例,诊断率为55%。2组出血量及脑灌注参数BF、BV、PS差异有统计学意义(P<0.05),高血压出血量大于脑肿瘤卒中组,且高血压出血组脑灌注强于脑肿瘤卒中组。结论对脑组织非常规部位出血提高警惕,认真询问病史,仔细观察血肿的形态、周围组织结构,综合考虑或建议采取其他物理检查,方能减少误诊,CT检查方便迅速,是检测脑肿瘤卒中与高血压脑出血的主要方法,其中高血压脑出血的表现更加特异。
Objective To analyze the diagnostic value of CT in brain tumor stroke and brain hemorrhage in order to provide clinical references for treatment and diagnosis.Methods All of 40 cases with brain tumor stroke diagnosed by pathology or clinical data admitted to our hospital from April 2012 to June 2014 received CT scan and infusion weighted imaging within12 hours after onset of symptoms.At the same time,40 age and gender-matched cases with hypertensive cerebral hemorrhage were regarded as control group.We analyzed the diagnosis of brain tumor stroke and brain hemorrhage as well as cerebral perfusion parameters such as cerebral blood flow（CBF）,cerebral blood volume（CBV）and capillary permeability surface（PS）.Results Of the 40 cases with brain tumor stroke,22 cases were definitely diagnosed but 18 cases were misdiagnosed as simple cerebral hemorrhage with the diagnostic rate of 55%.The amount of blood loss and values of BF,BV and PS between two groups disclosed statistical differences（P〈0.05）,which indicated that the control group had more blood loss and stronger cerebral infusion than study group.Conclusion We should step up the vigilance in non-routine bleeding zones of brain,carefully inquire medical history,seriously observe the form of hematoma and surrounding structures and comprehensively adopt various physical examinations to reduce misdiagnosis.CT scan may be an easy and quick examination to detect brain tumor stroke and brain hemorrhage in which the CT scan may show more specific performances.
出处
《中国实用神经疾病杂志》
2016年第22期1-2,共2页
Chinese Journal of Practical Nervous Diseases
关键词
脑肿瘤卒中
脑出血
CT
鉴别诊断
Brain tumor apoplexy
Cerebral hemorrhage
CT
Differential diagnosis
