CT在脑胶质瘤卒中与单纯脑出血鉴别诊断中的应用

Application of CT in the differential diagnosis of stroke- like glioma and cerebral hemorrhage

目的:观察和探讨CT在脑胶质瘤卒中和单纯脑出血鉴别诊断中的应用效果,以期为临床鉴别两种疾病提供客观的理论依据。方法:入选2009年1月至2015年1月于本院就诊的单纯脑出血患者30例(观察A组)和脑胶质瘤卒中患者30例(观察B组)作为研究对象,针对两组患者的临床资料和CT检查情况进行对比分析,以期为鉴别诊断做出贡献。结果:观察对比A组和B组患者脑出血情况结果,A组患者最大出血量为60ml,最小出血量为7.3ml;而B组患者最大出血量为40ml,最小出血量为3.2ml;对比分析显示,A组患者平均脑出血量明显大于B组,差异具有显著性(P<0.05);针对A组和B组患者的CT灌注参数进行对比分析,结果显示A组患者血流量(BF)、血容量(BV)及表面通透性(PS)值均较B组患者高,差异较显著(P<0.05)。单纯脑出血患者CT呈现明显密度增高阴影,形状和大小多呈现基底节区出血,肾形居多,内侧明显凹陷,而外侧往往发生膨隆;脑胶质瘤卒中患者CT多呈现边界清晰的高密度血肿,多数可见肿瘤实体,出血灶形态和大小均不同,呈现不均匀性,有半数以上的患者存在明显占位效应。结论:针对脑胶质瘤卒中患者应及时采取CT检查,结合临床病史等资料进行综合鉴别诊断,尽早与单纯脑出血进行区分诊断,及时进行针对性治疗,值得临床加以重视。

Objective： To study the clinical effect of CT in the differential diagnosis of stroke- like glioma and cerebral hemorrhage. Methods： Thirty patients with cerebral hemorrhage（ Group A） and 30 patients with stroke- like glioma（ Group B） were selected. The clinical data and CT examination results were analyzed. Results： The maximal blood loss and minimal blood loss of Group A was 60 ml and 7. 3ml,the for Group B was 40 ml and 3. 2ml（ P〈0. 05）.The value of BF,BV and PS for Group A was higher than that of Group B（ P〈0. 05）. For cerebral hemorrhage patients,the image of CT was majorly presented with the increasing density and shadow,basal ganglia hemorrhage,kidney shape,obvious hollows in the inner side and swelling condition in the external side. For stroke- like glioma patients,it was majorly presented with clear boundary and high density of hematoma. In most cases,there were the entities of tumor. The form and size of bleeding lesion was presented in a non- uniform way. The occupied effect was presented for the majority of the patients. Conclusion： For patients with stroke- like glioma,the prompt examination of CT and the reference of clinical data can make a differentital diagnosis with cerebral hemorrhage and make the corresponding therapy.