52例蛛网膜下腔出血与100例正常颅脑的CT对比研究
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摘要
目的：对蛛网膜下腔出血(SAH)与正常颅脑的头颅CT作对比研究，旨在提高即时确诊蛛网膜下腔出血的能力。
方法：搜集经CT复查确诊蛛网膜下腔出血52例，另取自我科正常颅脑CT资料100例作对比。均作轴位CT扫描。并按Zimmerman等提法，将大脑镰及纵裂池以胼胝体和侧脑室为界分为上、前及后三部分分析。
结果：蛛网膜下腔出血可显示脑池、脑沟、脑裂呈高密度改变；纵裂池出血呈一稍宽线影；高密度“Z”字征；前纵裂池高密度线影延长或大于1／2胼胝体膝部深度或大于25mm；天幕缘切迹增厚。
结论：CT在SAH的诊断中具有很高的敏感性，为临床诊断的首选检查方法。
Objective: Contrast study of CT on normal cranial and the subarachnoid hemorrhage to improve the ability to definite diagnosing promptly of SAH.
Methods: 52 CT scanning cases of SAH were collected, which were definitely diagnosed as such by correlation with their repeated CT scanning. In addition, 100 cases of normal cranial CT scanning were gathered consecutively from our department for comparison. Axial CT scanning were performed in all of them. The cerebral falx and the interhemispheric fissure cistern were divided into superior, anterior and posterior segments by the corpus callosum and the lateral ventricles according to Zimmerman's description.
Results: SAH were presented real image of brain cistern and brain sulcus; Hemorrhage in the interhemispheric fissure cistern presented as a slightly widening hyperdense line; zigzag hyperdense line; elongation of hyperdense line within the anterior segment of the interhemispheric fissure, which was longer than 25mm or half the depth of the genu; thickening of the tentorial incisure margin.
Conclusion: CT has a high specificity in SAH diagnosis, thus it is considered as the first -choice auxiliary examination method for clinical diagnosis.
方法：搜集经CT复查确诊蛛网膜下腔出血52例，另取自我科正常颅脑CT资料100例作对比。均作轴位CT扫描。并按Zimmerman等提法，将大脑镰及纵裂池以胼胝体和侧脑室为界分为上、前及后三部分分析。
结果：蛛网膜下腔出血可显示脑池、脑沟、脑裂呈高密度改变；纵裂池出血呈一稍宽线影；高密度“Z”字征；前纵裂池高密度线影延长或大于1／2胼胝体膝部深度或大于25mm；天幕缘切迹增厚。
结论：CT在SAH的诊断中具有很高的敏感性，为临床诊断的首选检查方法。
Objective: Contrast study of CT on normal cranial and the subarachnoid hemorrhage to improve the ability to definite diagnosing promptly of SAH.
Methods: 52 CT scanning cases of SAH were collected, which were definitely diagnosed as such by correlation with their repeated CT scanning. In addition, 100 cases of normal cranial CT scanning were gathered consecutively from our department for comparison. Axial CT scanning were performed in all of them. The cerebral falx and the interhemispheric fissure cistern were divided into superior, anterior and posterior segments by the corpus callosum and the lateral ventricles according to Zimmerman's description.
Results: SAH were presented real image of brain cistern and brain sulcus; Hemorrhage in the interhemispheric fissure cistern presented as a slightly widening hyperdense line; zigzag hyperdense line; elongation of hyperdense line within the anterior segment of the interhemispheric fissure, which was longer than 25mm or half the depth of the genu; thickening of the tentorial incisure margin.
Conclusion: CT has a high specificity in SAH diagnosis, thus it is considered as the first -choice auxiliary examination method for clinical diagnosis.
引文
1、Zimmerman RD, Yurberg E, Russell EJ. el al Falx and interhemisheric fissure on axial CT:I. normal anatomy. AJR, 1982,138:899
2、王维治，杨春晓．应该重视蛛网膜下腔出血的临床误诊问题，国外医学脑血管疾病分册，2000，8；8(4)，195～198
3、贾树忠，王帅辉，朱松君，等，急性颅脑外伤CT所见脑池出血43例分析，中华神经外科杂志，1996，12(6)385～386
4、王颖，肖有成，雷振汉，等．急性颅脑外伤CT表现，临床医学影像杂志，1994，5(2)；74～76
5、李廷，范宝瑜，赵欣春，等．自发性蛛网膜下腔出血1000例的CT诊断，中华放射学杂志，1999，33(2)：94～96
2、王维治，杨春晓．应该重视蛛网膜下腔出血的临床误诊问题，国外医学脑血管疾病分册，2000，8；8(4)，195～198
3、贾树忠，王帅辉，朱松君，等，急性颅脑外伤CT所见脑池出血43例分析，中华神经外科杂志，1996，12(6)385～386
4、王颖，肖有成，雷振汉，等．急性颅脑外伤CT表现，临床医学影像杂志，1994，5(2)；74～76
5、李廷，范宝瑜，赵欣春，等．自发性蛛网膜下腔出血1000例的CT诊断，中华放射学杂志，1999，33(2)：94～96
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