64例内部硬膜下血肿的CT和MRI表现

The CT and MRI manifestations of internal subdural hematoma

目的:分析颅脑内部硬膜下血肿的CT和MRI表现,提高诊断准确率。方法:回顾性分析64例经临床证实的内部硬膜下血肿的CT和MRI表现。结果:①64例内部硬膜下血肿可分为2类,大脑镰旁23例,小脑幕区41例;②CT表现:大脑镰旁硬膜下血肿多为单侧,内表面与大脑镰相贴、外表面呈弧形或波浪状高密度影;小脑幕区硬膜下血肿可位于幕上、幕切迹及幕下,形态多样。血肿边界清楚,不进入邻近脑沟和脑池;③MRI表现:一般各系列均呈高信号,FLAIR显示最清晰,以T1WI高信号为特征;横断面形态与CT类似,冠状面显示血肿范围更清楚。结论:内部硬膜下血肿CT和MRI表现有特征性;MRI显示血肿形态及分布较CT更优越;亚急性期以后复查时可行MRI以免漏诊。

Objective： To analyze the CT and MRI manifestations of internal subdural hematoma（ISDH） and to improve the accuracy of the diagnosis.Methods： The CT and MRI characteristics of the 64 cases with clinically confirmed ISDH were reviewed.Results： ①The 64 cases could be divided into 2 types,23 cases were about the falx cerebri and 41 Cases were about the cerebellar tentorium.②On CT imaging,ISDH beside the cerebral falx were mostly unilateral high density with interior surface sticking to the falx and arc or wave exterior,and that about the cerebellar tentorium might be supratentorial,subtentorial or at incisuratentori with various form.All ISDH had clear borders and didn’t extend to the near sulus or cisterna.③On MRI imaging commonly,all ISDH were high signal in every series images.They were the most clearly appeared in FLAIR,and their high signal in T1WI were characteristic.ISDH had the similar form with CT in axial images,while the extents were showed more clearly in coronal ones.Conclusion： There are characteristics of ISDH on CT and MRI imaging.MRI is superior to CT on displaying the form and distribution of ISDH.After the subacute phase,MRI should be used in reexamining for not missing diagnosis