CAJ | 학술논문

目的探讨常规超声及超声造影在脑外伤中的应用价值.方法 ①10只健康犬,麻醉满意后开颅.暴露硬脑膜后以不同外力制造加速性脑损伤模型.对不同病灶行常规超声及灰阶超声造影检查,实验结束后犬脑行病理学检查.②选取13例脑外伤患者行术中超声检查.应用常规超声检测病灶,确定外伤灶的位置、深度、大小、内部回声等.对血肿清除术中出现的急性脑膨出再行超声检查,以检测是否有迟发性血肿出现.选取8例脑外伤患者行术中超声造影检查.结果 ①10只实验犬中共有脑外伤灶12处,选取10处行超声造影检查,证实脑挫裂伤1处,脑挫伤伴出血1处,脑内血肿7处,脑内血肿破人脑室2处,脑内血肿包绕血管1处.②13例患者中,术前CT检查发现病变15处,术中超声发现病变18处.其中,术中超声发现对侧硬膜外血肿4例,1例经CT证实为对侧硬膜外血肿;3例超声诊断为硬膜外血肿后,在超声引导下将血肿清除.脑内血肿造影后边界清晰,出血区表现为无或低增强,而脑挫裂伤挫伤区内有造影剂进入;与二维超声比较,病变区范围变大.结论常规超声可清晰显示脑外伤灶,并对其进行精确定位.对于术中急性脑膨出,超声可发现颅内迟发性血肿并进行定位,不同类型脑外伤灶其超声造影表现不同.
목적 탐토상규초성급초성조영재뇌외상중적응용개치.방법 ①10지건강견,마취만의후개로.폭로경뇌막후이불동외력제조가속성뇌손상모형.대불동병조행상규초성급회계초성조영검사,실험결속후견뇌행병이학검사.②선취13례뇌외상환자행술중초성검사.응용상규초성검측병조,학정외상조적위치、심도、대소、내부회성등.대혈종청제술중출현적급성뇌팽출재행초성검사,이검측시부유지발성혈종출현.선취8례뇌외상환자행술중초성조영검사.결과 ①10지실험견중공유뇌외상조12처,선취10처행초성조영검사,증실뇌좌렬상1처,뇌좌상반출혈1처,뇌내혈종7처,뇌내혈종파인뇌실2처,뇌내혈종포요혈관1처.②13례환자중,술전CT검사발현병변15처,술중초성발현병변18처.기중,술중초성발현대측경막외혈종4례,1례경CT증실위대측경막외혈종;3례초성진단위경막외혈종후,재초성인도하장혈종청제.뇌내혈종조영후변계청석,출혈구표현위무혹저증강,이뇌좌렬상좌상구내유조영제진입;여이유초성비교,병변구범위변대.결론 상규초성가청석현시뇌외상조,병대기진행정학정위.대우술중급성뇌팽출,초성가발현로내지발성혈종병진행정위,불동류형뇌외상조기초성조영표현불동.
Objective To explore the value of contrast-enhanced ultrasonography(CEUS) in brain injuries. Methods ① Models of graded brain trauma were created in brains of 10 healthy mongrel dogs after the animals were anesthetized and the cranium were removed. Conventional ultrasonography(US) and CEUS were performed to observe the characteristics of traumatic region. ② Thirteen patients with traumatic brain injuries were collected to perform intraoperative ultrasonography. The location, depth, size, internal echo and boundary of traumatic brain injuries were clearly displayed. Eight injury sites were chosen to undergo CEUS. Results ① Twelve injury sites in brains of 10 dogs were detected,and CEUS were peformed in 10 lessions, of which 1 was diagnosed with cerebral contusion, 1 with cerebral contusion and cerebral hemorrhage, 7 with intracerebral hematoma, 2 with ventricular hematoma, 1 with blood vessels in intracerebral hematoma. ② Fifteen lesions were detected by preoperative CT scan, but 18 lessions were detected by intraoperative ultrasound. During operation epidural hematomas in 4 cases were detected. After CEUS,the area of lessions was clearly revealed to be extended, the hemorrhage area was exempt from enhancement while peripheral normal cerebral tissue was homogenously enhanced. Conclusions Conventional ultrasonography could display brain injuries. In case of accurate intraoperative encephalocele, intraoperative untrasound conduces to discover delayed intracranial hematoma. Different traumatic brain injuries had their special CEUS findings.