摘要
目的探讨脑出血患者血肿"管涌现象"的临床影像学特点,为脑出血患者的病情转归预测和治疗提供新的手段。方法选择发病1周内的、经头颅CT扫描检查证实的30例原发性脑出血患者,分别于入院时及发病90 d后进行头颅MRI检查,对比2次检查的磁敏感加权成像(SWI)序列结果,观察血肿周围以及远隔部位的各种形态出血灶,分析"管涌现象"的临床影像学特点。结果 30例患者入院时的SWI扫描图像均可见在血肿周围神经纤维周围间隙以及血肿远隔部位的血管周围间隙内存在不同程度的"管涌现象"病灶。在血管周围间隙内的"管涌现象"病灶呈环状分布,围绕在小血管周围;分布在血肿周围神经纤维周围间隙内以及远隔部位血管周围间隙内的"管涌现象"病灶呈指状分布,主要发现于基底节区及脑叶;不规则血肿周围均可见指状分布的"管涌现象"病灶。发病90 d后,大部分病灶已消失或仅有少许较分散的残留现象。结论 "管涌现象"广泛存在于脑出血的血肿周围组织内,同时也可见于部分远隔部位。
Objective To investigate the clinical imaging characteristics of the "piping phenomenon"of the hematoma in patients with cerebral hemorrhage,aiming to provide a novel approach for predicting clinical prognosis and clinical treatment. Methods Thirty patients with primary cerebral hemorrhage within 1 week of onset diagnosed by CT scan of the head were recruited in this investigation. Cranial MRI was performed upon admission and 90 d after onset. The results of twice susceptibility-weighted imaging( SWI) sequence were compared. The morphology of the hemorrhagic lesions surrounding and distant from the hematoma was observed. The clinical imaging characteristics of "piping phenomenon"were analyzed. Results Upon admission,the lesions with varying degree of"piping phenomenon"were observed between the nerve fiber space surrounding the hematoma and the peri-vascular space distant from the hematoma. The "piping phenomenon"lesions within the peri-vascular space were distributed in a ring-like pattern,surrounding the small vessels.Those lesions within the nerve fiber space surrounding the hematoma and the peri-vascular space distant from the hematoma were distributed in a finger-shape manner,mainly detected in the basal ganglia and cerebral lobe. The"piping phenomenon"lesions distributed in a finger-shape pattern were observed surrounding all the irregular hematoma. At 90 d after onset,a majority of lesions disappeared and merely few residual lesions were dispersive distributed. Conclusions The"piping phenomenon"is prevalent in the tissues surrounding the hematoma in cerebral hemorrhage patients,occasionally in the distant sites. Early detection of the "piping phenomenon"lesions distributed in a finger-shape pattern adjacent to the hematoma predicts the possibility of hematoma enlargement and poor prognosis.
出处
《新医学》
2017年第12期849-852,共4页
Journal of New Medicine
基金
国家自然科学基金(61072033)
广东省自然科学基金(8151051501000053
10151051501000076)
关键词
脑出血
血肿
管涌现象
磁共振
磁敏感加权成像
Cerebral hemorrhage
Hematoma
Piping phenomenon
Magnetic resonance imaging
Susceptibility-weighted imaging
