慢性硬膜下血肿MRI表现和不同手术方法与其复发的关系

Relationship between recurrence and preoperative MRI findings as well as different operative methods in patients with chronic subdural hematoma

目的探讨慢性硬膜下血肿(CSDH)术前MRI表现和不同手术方法与其复发的关系。方法回顾分析126例(共149个血肿)CSDH术前MRI资料,依血肿在MRI T1WI的表现分为高信号组(62例)和非高信号组(64例);又依治疗方法的不同,分为单纯钻孔冲洗治疗组和钻孔冲洗+闭式引流治疗组,分别比较其复发率。结果高信号组和非高信号组复发率分为4%和17.6%,高信号组复发率低于非高信号组(P<0.05);钻孔引流组复发率(6.1%)低于单纯钻孔组复发率(16.4%)(P<0.05)。结论CSDH术前MRI表现可以预测其复发率,采用闭式引流可以明显地减少其复发率。

Objective To investigate the relationship between the recurrence of chronic subdural hematoma （CSDH） and its preoperative MRI findings as well as different surgical methods, Methods The data of preoperative MRI were analyzed retrospectively in 126 patients with CSDH, who were divided into high intense signal group and non-high intense signal group on the basis of the menifestation on T1 weighted MR images, and into simple holing irrigation （SHI） group and holing irrigation with closed system drainage （HICSD） group according to the different treatment methods. The recurrence rate of CSDH was compared respectively. Results The recurrence rate （4%） in the high-intense signal group was significantly lower than that （17.6%） in the non-high-intense signal group （ P 〈 0.05）, There was a significant difference in recurrence rate between SHI （16.4 % ） and HICSD （6. 1 % ） group （ P 〈 0.05）, Condusion MRI is helpful to predict CSDH recurrence, The closed system drainage can significantly reduce recurrent rate in patients with CSDH.