CT观察脑挫裂伤时第三脑室及基底池形态改变的临床意义

Clinical significance of morphological observation of third ventricle and basal cistern with CT scan in the patients with brain contusion and laceration

目的探讨脑挫裂伤时第三脑室及基底池影像学征象改变的临床意义。方法对126例脑挫裂伤患者影像学资料进行回顾分析。根据首次CT扫描第三脑室和基底池形态改变分为4组,Ⅰ组(33例):第三脑室和基底池形态正常;Ⅱ组(31例):第三脑室呈条形或基底池轻度受压;Ⅲ组(32例):第三脑室呈线形和基底池明显受压;Ⅳ组(30例):第三脑室和基底池均消失。观察第三脑室及基底池改变与GCS评分、治疗方案及预后的关系。结果第三脑室和基底池形态与GCS评分、治疗方案密切相关,第三脑室和基底池形态改变越明显,恢复越差,病死率越高,各组间比较差异有显著性意义(P<0.01)。结论第三脑室和基底池形态的改变与脑挫裂伤预后密切相关,是判断预后的有效指标。

Objective To study the clinical significance of observing the morphological changes of third ventricle and basal cistern on CT scanning in the patients suffering from brain contusion and laceration. Methods A prospective study was carried out on the imaging data of 126 successively hospitalized cases of brain contusion and laceration. According to the morphological changes of third ventricle and basal cisterns on the initial CT images, the 126 cases were divided into 4 groups： normal third ventricle and basal cistern group （n=33）, gently compressed group （n=31）, severely compressed group （n=32）, absent group （n=30）. The relationship between the state of third ventricle and basal cistern and the GCS score and the treatment strategies and the prognosis of patients were analyzed statistically. Results There was a significant relationship between the state of third ventricle and basal cistern and the GCS score and the treatment strategies, and the more obvious the morphological changes of third ventricle and basal cistern were, the worse the prognosis was and the higher the fatality was, and the difference was significant statistically among the 4 groups （P〈0.01）. Conclusion There was a significant relationship between the state of third ventricle and basal cistern and the prognosis of the patients of acute brain contusion and laceration, so it can provide useful information about the patients＇ prognosis.