弥漫性轴索损伤的CT诊断探讨

CT diagnosis analyze of diffuse axonal injury

目的:探讨弥漫性轴索损伤的CT特征。方法:回顾性分析6例弥漫性轴索损伤患者的CT表现,所有患者均在伤后24 h内接受CT检查。结果:CT检查示5例患者脑内见斑片状高密度出血灶,1例患者脑内见斑片状低密度灶。6例患者中线均无明显偏移。出血灶位于大脑皮层者5例,位于脑干者3例,位于脑白质者3例,位于胼胝体者2例。3例患者脑室内出血,2例患者蛛网膜下腔出血,1例患者额、颞叶见斑片状低密度影。1例患者脑肿胀。6例患者伴颅骨骨折或头皮下软组织肿胀或副鼻窦积液或肺挫伤。结论:弥漫性轴索损伤患者病情危重,CT为首选检查,CT表现可为临床诊断提供重要依据。

Objective： To explore the CT imaging characteristic of diffuse axonal injury.Methods： 6 cases of diffuse axonal injury that had multi-slice spiral CT examination within 24h after trauma were retrospectively analyzed.Results： 5 cases had patchy intracerebral high-density hemorrhage.1 case had patchy intracerebral low-density shadows.No obvious displacement of median line was showed.5 cases had intracerebral hemorrhage at gray-white mater interface.3 cases had intracerebral hemorrhage at brain stem.3 cases had intracerebral hemorrhage at white mater.2 cases had intracerebral hemorrhage at corpus callosum.3 cases had interventricular hemorrhage.2 cases had subarachnoid hemorrhage.1 case had patchy intracerebral low-density shadows in frontal lobe and temporal lobe.1 case had cerebral swelling.6 cases also had skull fracture,scalp hematoma,fluid accumulation in sinus or pulmonary trauma.Conclusion： Cases of diffuse axonal injury have serious degree of injury.CT is the preferred method of the emergency examination.CT is able to provide important information for diagnosis of diffuse axonal injury.