目的 分析神经胶质细胞瘤与脑 出血的CT影像学特征及其诊断价值。方 法 回顾性分析2015年7月-2018年2月于我 院首诊的神经胶质细胞瘤及脑出血患者各 30例，对比其CT影像特征及脑灌注相关 参数局部脑血流量(CBF)、局部脑血容量 (CBV)、平均通过时间(MTT)、表面通透性 (PS)。结果 30例神经胶质细胞瘤，13例 病灶位于脑边缘部，脑皮质10例，基底节 区7例，出血灶区形态均欠规则，且大小 不一，蛛网膜下腔出血9例，均可见边界 清晰、边缘锐利的高密度影，17例高密度 出血灶掩盖软组织，8例高密度出血灶伴 囊变，24例病灶周围有明显水肿带，21例 有明显占位效应，增强扫描均可见病灶组 织有不同程度强化，以环状(13例)、片状 (8例)或结节状(9例)强化为主；30例脑出 血患者中，21例病灶位于基底节区，4例 位于小脑，3例位于脑干，2例位于脑叶， 2例破入脑室，CT可见高密度均匀影，呈 类圆形，仅4例表现为出血灶周围轻微水 肿，增强扫描无明显强化；两种病变CT值 比较差异无统计学意义(P＞0.05)，但神 经胶质细胞瘤患者病灶不具特异性，而脑 出血多位于基底节区，且灶周明显水肿、 占位效应例数显著高于脑出血；CBF、 CBV、MTT、PS等参数均显著低于脑出血(P ＜0.001)。结论 神经胶质细胞瘤与脑出 血的CT影像在病灶位置、水肿、占位效应 上有显著差异，且脑灌注相关参数也呈特 异性表达，有潜力成为疾病诊断鉴别提供 较高的参考价值。

Objective To analyze the CT features and the diagnostic value of gliomas and cerebral hemorrhage. Methods A retrospective analysis was performed on 30 patients with gliomas and 30 patients with cerebral hemorrhage who were initially diagnosed in the hospital during the period from July 2015 to February 2018. CT features, cerebral perfusion associated parameters cerebral blood flow(CBF), regional cerebral blood volume(CBV), mean transit time(MTT) and permeability surface(PS) were compared. Results Of the 30 cases of gliomas, 13 cases were located in limbic brain, 10 cases in cerebral cortex and 7 cases in basal ganglia region. The shapes of hemorrhagic foci were not regular, and different in size. There were 9 cases of subarachnoid hemorrhage, showing high-density shadows with clear and sharp edges. There were 17 cases of high-density hemorrhage covered soft tissue, 8 cases of high-density hemorrhage with cystic changes, 24 cases of edema around the lesion and 21 cases of obvious mass effect. Enhanced scan showed that the lesions were enhanced in different degrees, and the enhancement mainly was ring-like (13 cases), flake-like (8 cases) or nodular (9 cases). In 30 cases of cerebral hemorrhage, 21 cases were located in the basal ganglia region, 4 cases in the cerebellum, 3 cases in the brainstem, 2 cases in the lobe and 2 cases in the ventricle. CT showed highdensity homogeneous shadows and they were quasi-circular. There were 4 cases of mild edema around the hemorrhage and enhanced scan showed no obvious enhancement. There was no significant difference in CT values between the two kinds of lesions (p>0.05). Lesions of gliomas were not specific, and the cerebral hemorrhage was mostly located in the basal ganglia region. Cases with obvious edema around the lesion and mass effects are significantly more than those in patients with cerebral hemorrhage. CBF, CBV, MTT and PS were significantly lower than those of cerebral hemorrhage (P<0.001). Conclusion The CT images of gliomas and cerebral hemorrhage are significantly different in location, edema and mass effect, and the parameters related to cerebral perfusion are also specific, which provides high-value references for the diagnosis and differential diagnosis.