53例颅脑创伤患者耳部损伤的临床表现与多层螺旋CT发现的相关性研究

Correlation research between clinical manifestation and findings on multislice computed tomography in 53 craniocerebral injury patients with aural trauma

目的探讨颅脑创伤病人耳部损伤的临床表现与多层螺旋CT发现的相关性。方法对53例颅脑创伤疑有耳部和面神经管损伤的患者进行了耳部CT扫描和3D图像重组,统计、分析各型颞骨骨折CT所见与临床症状、体征的相关性。结果本组53例颞骨骨折,其中纵行骨折34例(64.2%),混合性骨折14例(26.4%),横行骨折5例(9.4%);内耳完整型48例(90.6%),内耳受损型5例(9.4%)。脑挫裂伤或(和)脑内血肿21例:其中单侧颞叶损伤11例、双侧5例,弥漫性轴索损伤1例,脑干损伤1例;硬膜外或(和)硬膜下血肿8例,蛛网膜下腔积血6例。结论多层螺旋CT(MSCT)3D成像技术立体、直观、真实地再现了耳部及面神经管细微、复杂的影像学解剖和病理改变,可为临床早期诊断,及时选择合理、恰当的治疗方案以及预后评估等提供较好的影像学依据。

Objective To discuss the correlation between clinical manifestation and findings on imaging provided by muhisliee computed tomography （MSCT} in craniocerebral injury patients with aural trauma. Methods High-resolution CT scanning and three-dimensional reconstruction had been performed in 53 patients with suspected temporal bone fracture. The features of MSCT three - dimensional, imagings of temporal bone fracture and the correlation between CT findings and clinical symptoms were analyzed. Results CT showed temporal hone fracture in 53 patients. Among them, longitudinal fractures were detected in 34 patients, transverse fractures in 5 patients and mixed fractures in 14 patients. Totally 48 patients had good inner ear and 5 patients had inner ear damaged. Contusions of brain and/or intracerebral hematomas were detected in 21 patients：unilateral temporal 10be injuries in 11 patients,bilateral in 5 patients ,diffuse axonal injury and brain stem injury in 1 patient, respectively ; epidural and/ or subdural hematomas in 8 patients, subarachnoid space haematocele in 6 patients. Conclusion MSCT three-di- mensional imagings can clearly display complex anatomic structures and pathologic changes of temporal bone, and also can provide better imaging information for early diagnosis and reasonable treatment.