CT定量分析技术在诊治慢性硬膜下血肿的临床应用

Clinical application of quantitative CT analysis in the treatment of chronic subdural hematoma

目的使用CT定量分析技术研究围手术期慢性硬膜下血肿(CSDH)变化与术后血肿复发的相关性。方法本研究纳入54例CSDH病例,共含血肿64个。研究围手术期多项典型CT指标与术后血肿复发率之间的相关性。结果 11例病人(20.4%)出现术后血肿复发。术前血肿量较大(>120 ml)和(或)出院前硬膜下残液量较大(>22 ml)者术后复发率显著升高;而当硬膜下积液量小于上述阈值时,血肿不复发率分别为92.7%和95.2%。术前血肿宽度较大(>15.1 mm)和(或)术后残余血肿腔宽度较大(>11.7 mm)的CSDH病人术后复发率也明显上升。结论 CT定量容积分析技术证明术后血肿"自我吸收期"硬膜下残余积液量的变化是预测血肿复发的一种有效影像学指标。

Objective To investigate the relationship between hematoma recurrence and changes in the volume of chronic subdural hematoma （CSDH） during the perioperative period using CT volumetric analysis. Methods The study involved 54 cases of CSDH patients, including 64 hematoma. The association between recurrence rate and CT findings was investigated. Results Eleven patients （20.4 %） experienced postoperative recurrence. A higher pre-operative （〉 120 ml） hematoma volume and/or pre-discharge subdural fluid volume （〉 22 ml） were significantly associated with higher recurrence. The probability of non-recurrence for values below these thresholds was 92.7 % and 95.2 % respectively. CSDH with larger preoperative （〉 15.1 mm） and/or residual widths （〉 11.7 mm） also had significantly increased recurrence rates. Conclusions Volumetric quantitative CT can provide strong evidence that changes in the residual fluid volume during the ＂self-resolution＂ period can be used as significant radiological predictors of recurrence.