自发性小脑出血的临床与影像学诊断研究

Clinical and Imaging Diagnosis Study on Spontaneous Cerebellar Hemorrhage

目的：探讨CT和MRI对自发性小脑出血的诊断价值度对临床治疗的指导作用。材料和方法：回顾分析21例自发性小脑出血的临床及影像检查资料。结果：21例中15例有高血压病史（71．4％），其中小脑半球出血14例（左侧9例，右侧5例）、小脑蚓部出血4例、混合性出血3例．11例行MRI检查，其中3例急性期出血在T1WI表现为低和等信号，在T2WI表现为不均匀高信号；8例亚急性期出血在T1WI和T2WI均表现为环形高信号。10例小量出血、6例中量出血均经内科保守治疗痊愈，2例中量出血、2例大量出血经外科手术治疗好转，1例大量出血病例未手术治疗死亡。结论：高血压是小脑出血的主要原因；诊断小脑出血首选CT；MRI可用于小脑出血的诊断分期及随访；CT和MRI可为小脑出血治疗方法的选择提供指导。

Objective To study the clinical and Imaging diagnosis value of spontaneous cerebellar hemorrhage, and to direct clinical therapy. Methods The clinical and imaging examination data of 21 patients with spontaneous cerebellar hemorrhage were analyzed retrospectively. Results Among the 21 patients, 15 patients have hypertension （71.4%）. 14 cases were cerebellar hemisphere hemorrhage, 4 cases were vermiform process of cerebellum hemorrhage, and 3 cases were mixed hemorrhage. 11 patients were performed MRI examination. 3 acute hemorrhage lesions showed isointensity signal or hypointensity signal on T1WI, and uneven hyperintensity signal On T2WI. 8 subacute lesions showed ring--shaped hyperintensity signal on T1WI and T2WI images. 10 paucity hemorrhage and 6 middle bleeding were cured by internal medicine expectant treatment. 2 middle bleeding and 2 massive hemorrhage took a turn for the better after surgery treatment. 1 patient with massive hemorrhage died because of no surgery promptly. Conclusions Hypertension was the main cause of spontaneous cerebellar hemorrhage. CT was the first choice for the diagnosis of spontaneous cerebellar hemorrhage. MRI can be used for the stage diagnosis and of spontaneous cerebellar hemorrhage and follow up. CT and MRI examination can help the clinic to choice correct treatment method for spontaneous cerebellar hemorrhage.