CAJ | 학술논문

目的探讨超薄多层螺旋CT、颅骨三维图像重建和脑灌注成像在急性颅脑外伤动态变化中的临床应用价值.方法收集2009年12月至2011年10月我院收治的245例急性颅脑外伤(TBI)检查资料,均于伤后3-6h行常规多层螺旋CT(MSCT),超薄多层螺旋CT以及颅骨三维图像重建和脑CT灌注成像(CTP)检查,全部病例于伤后2-7d动态复查MSCT和超薄MSCT,将数据进行回顾性分析,采用卡方检验评价.结果超薄MSCT在脑挫裂伤、脑内血肿诊断中优于常规MSCT;CTP除弥漫性轴索损伤无统计学意义外,其余明显优于常规MSCT;CTP在脑挫裂伤、硬膜下血肿和脑内血肿优于超薄MSCT差异具有统计学意义(P＜0.05).颅骨三维图像重建在对颅骨骨折的检查优势明显.结论联合应用超薄MSCT、颅骨三维图像重建和CTP对于急性颅脑外伤早期和微小损伤的诊断优于常规MSCT,可以降低误诊率,并为早期治疗和预后判断提供可靠的依据.
목적 탐토초박다층라선CT、로골삼유도상중건화뇌관주성상재급성로뇌외상동태변화중적림상응용개치.방법 수집2009년12월지2011년10월아원수치적245례급성로뇌외상(TBI)검사자료,균우상후3-6h행상규다층라선CT(MSCT),초박다층라선CT이급로골삼유도상중건화뇌CT관주성상(CTP)검사,전부병례우상후2-7d동태복사MSCT화초박MSCT,장수거진행회고성분석,채용잡방검험평개.결과 초박MSCT재뇌좌렬상、뇌내혈종진단중우우상규MSCT;CTP제미만성축색손상무통계학의의외,기여명현우우상규MSCT;CTP재뇌좌렬상、경막하혈종화뇌내혈종우우초박MSCT차이구유통계학의의(P＜0.05).로골삼유도상중건재대로골골절적검사우세명현.결론 연합응용초박MSCT、로골삼유도상중건화CTP대우급성로뇌외상조기화미소손상적진단우우상규MSCT,가이강저오진솔,병위조기치료화예후판단제공가고적의거.
Objective Discussion of ultrathin multilayer spiral CT 3D image reconstruction,skull and brain perfusion imaging in acute brain injury to dynamic changes in the clinical value.Methods 2009December to 2011 October were collected in our hospital in 245 patients with acute traumatic brain injury patients check information,both in the 3-6 h after injury within conventional multislice spiral CT,thin multilayer spiral CT and three-dimensional image reconstruction of skull and brain CT perfusion imaging examination,all the cases in 2 to 7 days after injury dynamic review of conventional MSCT and ultrathin multilayer spiral CT,the data were retrospectively analyzed,using the chi-squared test evaluation.Results Super thin multilayer spiral CT in cerebral contusion and laceration,intracerebral hematoma in TBI with mixed diagnosis has statistics difference is better than the conventional MSCT.CTP in acute traumatic brain injury diagnosis was superior to conventional MSCT except diffuse axonal injury.CTP in cerebral contusion and laceration,subdural hematoma and intracerebral hematoma associated with intracerebral hematoma in the diagnosis with statistical difference,better than the ultrathin multilayer spiral CT (P ＜ 0.05).The 3D image reconstruction of skull fracture demonstrated great advantages in the treatment of skull fracture,which include cranial suture separation and basal skull fracture.Conclusion combined Super thin multilayer spiral CT 3D image reconstruction skull and brain CT perfusion imaging for acute craniocerebral injury early diagnosis and minimal injury diagnosis is superior to conventional multislice spiral CT,The rate of misdiagnosis can be decreased.which provide Reliable basis for early diagnosis and Prognosis of TBI.