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急性闭合型颅脑损伤患者MRI及CT影像学特点比较

作者:林声造 沈长青

所属单位:海南省儋州市农垦那大医院放射科(海南 儋州 571700)

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摘要

目的 探讨MRI及CT在急性闭合 型颅脑损伤患者临床诊断中的价值及影 像学特点差异。方法 选取132例急性闭 合型颅脑损伤患者为研究对象,入院后均 接受MRI和CT检查,对比其影像学特点差 异。结果 CT和MRI两种检查方案在软组 织损伤、原发性出血及原发性神经损伤 中的表现特征基本一致;CT较MRI在颅骨 骨折表现上更为敏感,粉碎性骨折患者 可见游离骨碎片,线样骨折患者可见颅 骨板骨质不连续、部分颅缝加宽表现; MRI则多表现为T1、T2加权像低信号影。 结论 两种影像检查方式在软组织损伤、 原发性神经损伤及原发性出血等颅脑损 伤类型的影像学特点较为类似,CT在颅 骨骨折中的鉴别诊断价值优于MRI,建议 临床联合应用以提高诊断准确性。

Objective To investigate the value of MRI and CT in the clinical diagnosis of acute closed craniocerebral injury and the differences in imaging features. Methods 132 patients with acute closed craniocerebral injury were enrolled in the study. After admission, all patients underwent MRI and CT examination, and the imaging features were compared. Results The imaging features of CT and MRI were basically coincident in soft tissue injury, primary hemorrhage and primary nerve injury. CT was more sensitive than MRI in displaying skull fractures. There were free bone fragments in patients with comminuted fractures, and there were skull bone plate discontinuity and part of the skull gap widening in patients with line-like fractures. MRI showed low signal shadow on T1 and T2 weighted images. Conclusion The imaging features of CT and MRI are similar in soft tissue injury, primary hemorrhage and primary nerve injury type of craniocerebral injury. The value of CT is higher than MRI in the differential diagnosis of skull fractures. The combined use is suggested to improve the diagnostic accuracy.

【关键词】急性闭合型颅脑损伤;MRI; CT;诊断;影像学特点

【中图分类号】R445.3;R742

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.03.008

前言

临床研究表明,急性闭合型颅脑损伤具有起病急、危重程度高、 死亡风险高等特点[1],致伤后4h内是外科手术治疗的黄金期,需引起 临床重视。当前应用于该疾病早期诊断的影像学技术以CT和MRI为主, 其影像学表现特点和临床鉴别诊断价值也成为各学者探究的热点话 题[2]。本次研究以此为方向,选取132例急性闭合型颅脑损伤患者为研 究对象,均予以MRI和CT检查,以探讨两种影像学技术在急性闭合型颅 脑损伤患者临床诊断中的价值及影像学特点差异,现报告如下。