单纯外伤性蛛网膜下腔出血的CT诊断

CT diagnosis of singly traumatic subarachnoid hemorrhage

目的 探讨单纯外伤性蛛网膜下腔出血 (STSAH)的CT表现特征及其诊断价值 .方法 对 12 4例 STSAH患者的CT表现进行回顾性分析 ,其中 10 2例经 CT复查及治疗结果证实 .结果 STSAH的出血部位分布于 :大脑纵裂池 5 6例(4 5 .2 % ) ;脑干周围池 37例 (2 9.8% ) ;大脑侧裂池 2 2例(17.7% ) ;脑表面沟 9例 (7.3% ) .其主要 CT表现特征为 :1纵裂池染色半球面边缘毛糙征 ;2脑干周围池积血征 ;3侧裂池或脑表面沟铸型染色征 .结论 1CT据上述特征性表现可作出 STSAH诊断 ;2大脑纵裂池出血时的冠状位重建图像能为鉴别诊断提供更多有价值的信息 ;3CT复查有助于验证诊断和及时检出迟发性脑出血 .

AIM To investigate CT features of singly traumatic subarachnoid hemorrhage (STSAH) and their diagnostic value. METHODS CT features of 124 patients with STSAH were retrospectively analyzed. Of them, 102 cases were demonstrated by CT reexaminations and their therapeutic results. RESULTS The distributions of STSAH included cerebral longitudinal fissure cistern in 56 cases (45.2%), pe ripheral cistern of brain stem in 37 (29.8%), cerebral lateral fissure cistern in 22 (17.7%), and cerebral surface sulcus in 9 cases (7.3%). The main CT features included marginal spicular signs on the stained hemisphere of longitudinal fissure cistern, hematocele signs of the peripheral cistern of brain stem, and molding staining sings of the lateral fissure cistern or the brain surface sulcus. CONCLUSION A definite diagnosis of STSAH can be made according to the above CT features; In the hemorrhage of cerebral longitudinal fissure cistern, reconstructed images on the coronary site can provide more valuable information for differential diagnosis; CT reexaminations can aid doctors to test and verify the diagnosis and to find delayed cerebral hemorrhages.