颅底骨折首次CT检查假阴性的处理

Experiences of Diagnosis and Treatment of Fracture of Skull Base Demonstrated False Normal by First CT

目的探讨颅底骨折病例首次CT检查假阴性的原因及诊疗措施。方法回顾性分析我院2005～2009年收治隐匿性颅底骨折68例病例资料,归纳各种导致首次CT检查假阴性的原因及进一步诊疗措施。结果本组前颅窝骨折28例,中颅窝骨折33例,后颅窝骨折7例。结论造成CT检查假阴性的原因可分为三类:一是CT扫描厚度大;二是颅底解剖的复杂性;三是"亨氏暗区"CT检查盲点存在。对首次CT检查阴性的可疑颅底骨折病例,一定要将CT结果与临床表现及其他检查结果综合分析判断,必要时复查或留院观察以减少漏诊率。

Objective To explore the reasons and diagnosis and treatments of fracture of skull base demonstrated false normal by first CT. Methods 68 cases of hidden fracture of skull base demonstrated false normal by first CT were analyzed respectively during 2005 to 2009. Finally, all the cases were proved injured. Results Fracture of anterior fossa 28 cases, fracture of medial fossa 33 cases, fracture of posterior fossa 7 cases. Conclusion The reasons could be classified into three kinds as the thickness of CT is too big, the complicated of skull base and the influence of hounsfield dark area. So pictures, clinic manifestation, and other examination resuhs should be collected and analyzed.Escaping rate of diagnosis would be cut down if examination time by time, further CT scan and observation in hospital were performed.