论著-头颈部
紫绀型先心病颅脑CT的征象分析
作者:周 毅1,2 鱼博浪1 杨 健1 高燕军3
所属单位:1.西安交通大学医学院第一附属医院影像科(陕西 西安 710061) 2.陕西省中医医院影像科(陕西 西安 710003) 3.西安交通大学医学院附属西安市中心医院放射科(陕西 西安 710003)
PDF摘要
目的探讨紫绀型先心病患者颅 脑CT表现及分析上矢状窦密度和血红蛋白 (Hb)浓度、红细胞压积(HCT)、红细胞计 数(RBC)之间的关系。方法 收集52例临床 诊断为紫绀型先心病患者与50例正常健康 人脑部CT平扫图像进行研究比较,观察 图像并测量其上矢状CT值,并结合Hb、 HTC、RBC值进行统计学分析。结果 52例 紫绀型先心病患者中,脑部CT静脉窦及脑 血管血液密度正常5例(9.61%);血液密 度轻度增高15例(29.41%);中度增高18 例(34.61%);重度增高14例(26.92%), 以上矢状窦显示率最高。通过测量分析 上矢状窦CT值与Hb值呈明显正相关性; 紫绀型先心病患者上矢状窦CT值高于 CT正常组,差异具有显著统计学意义 (t=12.864,P<0.01)。结论 颅内静脉窦及 脑血管密度均匀性增高,是紫绀型先心病 颅脑CT平扫相对特征性改变;血液密度增 高与Hb、HCT、RBC增高相关,尤其上矢状 窦增高较为显著。
Objective To explore the cerebral CT imaging features in patients suffering cyanotic congenital heart disease and to analyze the relationship between sagittal sinus density, concentration of hemoglobin (Hb), red blood cells deposited (HCT),and the red blood cell count (RBC). Methods Preoperative cerebral CT imaging features in 52 patients with cyanotic congenital heart disease (CCHD group) were analyzed and relevant data were compared with the findings in normal healthy people (50 persons in this group ). To observe the images and to measure its superior sagittal sinus CT value, the concentration of Hb、HCT and RBC counts were referred to for statistical analysis. Results Among 52 cases of cyanotic congenital heart disease, normal cerebral CT sinus and cerebral blood density were found in 5 patients (9.61%); Blood density slightly increased in 15 cases (29.41%); Moderately increased in 18 cases (34.61%); Increased heavily in 14 cases (26.92%), especially sagittal sinus showed the highest rate. Measured and analyzed, an obvious parallel correlation between superior sagittal sinus CT value and Hb existed; The superior sagittal sinus CT value in patients with cyanotic congenital heart disease is higher than that in CT normal group, the difference has significant statistical significance (t=12.864,P<0.01). Conclusions Increased density of intracranial venous sinus and cerebral vascular is showed in cerebral CT scanning of CCHD Patients; Increased blood density is associated with increased hemoglobin concentration, especially the sagittal sinus is increased more significantly.
【关键词】紫绀型先天性心脏病;类增强改变;血红蛋白
【中图分类号】R445.3;R541.1
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2015.12.017
前言
紫绀型先天性心脏病(简称紫绀型先心病,CCHD)患者在外伤或其 他原因行颅脑CT平扫时颅内静脉窦及脑血管血液密度不同程度、范围 增高,严重者类似增强样改变;临床医师乃至影像科医师对该类患者 的脑部CT表现往往认识不足,易误诊为蛛网膜下腔出血、静脉窦血栓 等疾病,使临床诊疗走入误区。本研究采用脑部CT平扫,将CCHD患者 与健康人进行对比,并结合血常规指标对2组之间进行比较,初步分析 CCHD患者脑部形态学与血流动力学变化。
中国CT和MRI杂志
第13卷, 第 12 期
2015年12月
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