摘要
目的分析慢性硬膜下血肿(CSDH)患者术前CT和MRI图像对术中所见血肿液化程度的预测价值。方法选择青岛大学附属医院神经外科自2019年3月至2022年12月收治的69例CSDH患者(83侧)为研究对象,患者术前均行颅脑CT和(或)MRI检查。根据CT图像中血肿密度将血肿分为高、等和低密度3种,根据MRI图像中血肿信号均匀部分的比例将血肿分为均匀和不均匀2种。比较不同密度、信号均匀和不均匀血肿患者术中所见血肿液化程度的差异,总结特殊形态血肿患者术中所见血肿液化程度。结果共计58例CSDH患者(69侧)完成术前CT检查,CT图像中不同血肿密度患者术中血肿液化程度的差异有统计学意义(P<0.05),CT图像中等密度血肿患者术中血肿液化程度优于低密度血肿、高密度血肿(平均秩次分别为40.71、34.67、25.27)。共有50例CSDH患者(63侧)术前进行了MRI检查,MRI图像中血肿信号均匀患者术中血肿液化程度优于血肿信号不均匀患者(平均秩次分别为46.53、17.00),差异有统计学意义(P<0.05)。术前CT或MRI图像中表现为肥皂泡征的血肿术中均以血块为主;表现为液平和渐变特点的血肿术中大多液化良好。结论CSDH患者术前CT和(或)MRI图像可有效预测术中血肿的液化程度。
Objective To explore the predictive values of preoperative CT and MRI features in intraoperative liquefaction degrees of hematoma in patients with chronic subdural hematoma(CSDH).Methods Sixty-nine patients(83 sides)with CSDH,admitted to Department of Neurosurgery,Affiliated Hospital of Qingdao University were chosen;preoperative CT and/or MRI were performed in all patients.According to hematoma density in CT images,hematoma was divided into high-density,medium density and low-density hematoma;according to the proportion of hematoma part enjoying uniform signal in MRI images,hematoma was divided into heterogeneous signal hematoma and homogenized signal hematoma.The liquefaction degrees of hematoma in patients with different densities of hematoma,and heterogeneous signal hematoma and homogenized signal hematoma were compared,and the liquefaction degrees of hematoma in patients with special-shaped hematoma were summarized.Results A total of 58 patients(69 sides)with CSDH completed preoperative CT examination;the intraoperative liquefaction degrees of hematoma in patients with different hematoma densities in CT images were significantly different(P<0.05);the liquefaction degree of hematoma in patients with medium density hematoma was better than that of high-density hematoma and low-density hematoma(average rank:40.71,34.67 and 25.27).A total of 50 patients(63 sides)with CSDH completed preoperative MRI examination;the intraoperative liquefaction degrees of hematoma in patients with homogenized signal hematoma was better than that of heterogeneous signal hematoma,with significant difference(average rank:46.53 and 17.00,P<0.05).The hematoma with soapy signs on preoperative CT or MRI images had blood clots mainly.Hematoma with fluid-fluid levels and fluid gradual changes had good liquefaction.Conclusion Preoperative CT and(or)MRI images can effectively help to predict the intraoperative liquefaction degrees of hematoma in CSDH patients.
作者
焦迎斌
林强
王者
丰育功
Jiao Yingbin;Lin Qiang;Wang Zhe;Feng Yugong(Department of Neurosurgery,Affiliated Hospital of Qingdao University,Qingdao 266000,China)
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2023年第6期604-608,共5页
Chinese Journal of Neuromedicine
