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CT“李琦岛征”和 “黑洞征”对脑挫 裂伤血肿扩大的预 测价值*

作者:杨先春 吴汉斌 左 敏 李志浩

所属单位:武汉科技大学附属汉阳医院放射科 (湖北 武汉 430050)

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摘要

目的 探讨“李琦岛征”和“黑 洞征”对脑挫裂伤血肿扩大的预测价值。 方法 回顾性分析我院2016年1月至2017 年12月期间96例脑挫裂伤血肿扩大患者的 早期CT表现及临床资料,并评价“李琦岛 征”和“黑洞征”预测脑挫裂伤血肿扩大 的敏感性、特异性、阳性预测值和阴性预 测值。结果 412例脑挫裂伤血肿患者中经 CT随访复查确诊血肿扩大96例, 其中扩 大的血肿早期CT表现为“李琦岛征”44 例,“黑洞征”38例,其它14例;在脑挫 裂伤血肿扩大预测方面,“李琦岛征” 和“黑洞征”的敏感性分别为45.83%、 39.58%;特异性分别为96.52%、94.94%; 阳性预测值分别为80.00%、70.37%;阴 性预测值分别为85.43%、84.03%。结论 CT“李琦岛征”和“黑洞征”是脑挫裂伤 血肿可靠CT征象,可有效预测脑挫裂伤血 肿扩大的风险,“李琦岛征”和“黑洞 征”在脑挫裂伤患者血肿扩大的预测中有 重要价值。

Objective To explore the predictive value of "Li qi island sign" and "black hole sign" on the enlargement of hematoma in cerebral contusion and laceration. Methods a retrospective analysis in 96 cases of contusion and laceration of brain hematoma enlargement in patients our hospital from January 2016 to December 2017 with early CT findings and clinical data, and evaluate the "Li qi island sign " and "black holesign" the predictive value of sensitivity and specificity, positive predictive value and negative laceration hematoma enlargement in predicting cerebral contusion. Results 412 cases of cerebral contusion patients were followed by CT diagnosed hematoma enlargement in 96 cases, hematoma early manifestations of CT for expanding "Li qi island sign " in 44 cases, the "black hole" sign in 38 cases, the other 14 cases; in the prediction of cerebral contusion and laceration of hematoma expansion, "Li qi island sign" and "black hole.sign" the sensitivity was 45.83%, specificity was 39.58%; 96.52%, 94.94%; the positive predictive value were 80%, 70.37%; negative predictive value were 85.43%, 84.03%. Conclusion CT "Li qi island sign" and "black hole sign" are reliable CT signs of cerebral contusion and hematoma, which can effectively predict the risk of enlargement of hematoma in cerebral contusion and laceration. "Li qi island sign" and "black hole sign" are of great value in the prediction of hematoma enlargement in patients with cerebral contusion and laceration.

【关键词】“李琦岛征”;“黑洞征”; 血肿扩大;体层摄影术;X线 计算机

【中图分类号】R742

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2019.06.002

前言

脑挫裂伤是急性颅脑损伤高危因素之一,短期内脑挫裂伤血肿扩 大常导致患者病情急剧恶化,严重者可危及患者性命;脑挫裂伤血肿 扩大患者的致残率及致死率也居高不下[1]。及早预测脑挫裂伤血肿有 无扩大风险并提前干预治疗,是影响患者治疗和预后的关键。国内学 者李琦等[2-3]发现CT平扫“李琦岛征”和“黑洞征”对于脑出血血肿进 一步扩大有良好的预测价值。本研究旨在通过回顾性分析脑挫裂伤血 肿扩大患者早期CT表现及临床资料,评价脑挫裂伤出血早期CT“李琦 岛征”和“黑洞征”对血肿扩大的预测的价值,从而为临床评估脑挫 裂伤患者病情及提前干预治疗提供参考依据。