目的 分析颅脑损伤后精神障 碍的影像学表现。方法 选取2014年8月 至2016年9月我院收治的颅脑损伤后精 神障碍患者63例为研究对象，均行CT及 MRI检查，分析CT及MRI对颅脑损伤异常 部位的检出率及影像特点，对比CT及MRI 的诊断灵敏度、特异度、准确度，同时 评价Rotterdam CT评分在判断颅脑损 伤预后中的价值。结果 MRI共检出116 处部位异常，CT检查显示87处部位异 常，MRI对异常部位检出率80.0%高于CT 60.0%(P<0.05)；CT检查显示中型颅脑损 伤患者脑严重挫裂伤及脑水肿肿胀，见外 侧裂及脑池积血、创伤性蛛网膜下腔出 血，重型颅脑损伤患者右侧额颞少量硬膜 下血肿及左侧脑室后角积血，MRI显示颅 板骨质断裂者在T2WI线处见信号影，头 皮损伤检查中显示等T1、长T2信号影， 脑部受力同侧或对侧发生挫伤者MRI显示 皮质下片状异常信号影，T1WI见低信号 影，T2WI为高信号影，信号均匀；CT诊断 颅脑损伤后精神障碍的灵敏度、特异度 与MRI比较无显著差异(P>0.05)，但其准 确度61.90%低于MRI 79.37%(P<0.05)； Rotterdam CT评分为轻、中、重型患者的 死亡、中残及重残人数差异较大，具有统 计学意义(P<0.05)。结论 CT及MRI对颅脑 损伤后精神障碍均有一定诊断价值，且 MRI在准确性方面占优势，Rotterdam CT 评分可用于预后评估，值得在临床推广应 用。

Objective To analyze the imaging findings of mental disorders after craniocerebral injury. Methods A total of 63 patients with mental disorders after craniocerebral injury who were admitted to our hospital between August 2014 and September 2016 were selected as the study subjects. All patients were examined by CT and MRI. The detection rate and imaging findings of CT and MRI in abnormal sites of craniocerebral injury were analyzed. The diagnostic sensitivities, specificities and accuracies of CT and MRI were compared, and the value of Rotterdam CT score in evaluating the prognosis of craniocerebral injury was evaluated. Results MRI detected a total of 116 abnormal parts and CT detected 87 abnormal parts. The detection rate of MRI (80.0%) was higher than that of CT (60.0%) (P<0.05). CT examination showed severe contusion and laceration, brain edema and brain swelling, lateral fissure and brain cistern hematocele and traumatic subarachnoid hemorrhage in patients with moderate craniocerebral injury, little right frontotemporal subdural hematoma and left ventricle posterior horn hematocele in patients with severe craniocerebral injury. MRI showed signal on T2WI in patients with cranial plate fractures, equal T1 and long T2 signal in scalp injury. MRI showed subcortical patchy abnormal signals in patients with brain stress ipsilateral or contralateral contusion, low signal on T1WI, high signal on T2WI and homogeneous signal. The sensitivity and specificity showed no significant differences between CT and MRI in the diagnosis of mental disorders after craniocerebral injury (P>0.05). The accuracy was lower than that of MRI (61.90% vs 79.37%) (P<0.05). Rotterdam CT score showed significant differences between patients with mild, medium and severe disease (P<0.05). Conclusion Both CT and MRI are of certain value in the diagnosis of mental disorders after craniocerebral injury, and the accuracy of MRI is relatively higher. Rotterdam CT score can be used to assess the prognosis.