双侧额顶部硬膜下出血的CT及MRI影像特点分析

Analysis of CT and MRI Findings of Bilateral Frontoparietal Subdural Hemorrhage

目的分析双侧额顶部硬膜下出血的CT及MRI影像特点。方法收集我院2015年2月-2016年2月期间收治的48例双侧额顶部硬膜下出血患者的CT及MRI影像资料,分析其CT及MRI影像特点。结果 48例双侧额顶部硬膜下出血患者中20例行CT扫描检查,其中急性期7例,亚急性期11例,慢性期2例;28例行MRI扫描检查,其中急性期11例,亚急性期10例,慢性期7例。双侧额顶部硬膜下出血患者CT平扫可见双侧额顶部颅骨内板下方弧形等低密度影,血肿清晰,伴有骨质伪影,脑实质未见异常。MRI平扫轴位T1可见双侧额顶部颅骨内板下方弧形高信号影,邻近脑实质略受推挤;脑实质未见异常信号影,灰白质界面清楚,部分脑沟增宽加深脑回变浅,中线结构无偏移;MRI平扫轴位T2可见双侧额顶部颅骨内板下方弧形高信号影,颅底大血管形态及走形未见异常,颅骨骨髓信号正常;MRI平扫轴位FLAIR可见双侧额顶部颅骨内板下方弧形高信号影;e DWI未见弥散受限。结论 CT扫描可见双侧额顶部颅骨内板下方弧形等低密度影;血肿不清晰;MRI扫描轴位T1可见弧形高信号影,血肿清晰,中线结构无偏移;轴位T2可见弧形高信号影,轴位FLAIR可见弧形高信号影;e DWI未见弥散受限。双侧额顶部硬膜下出血的CT及MRI影像特点明确,临床应以MRI检查为主,CT检查为辅。

Objective To analyze the CT and MRI findings of bilateral frontoparietal subdural hemorrhage. Met：hods The CT and MRI data of 48 patients with bilateral frontoparietal subdural hemorrhage who were admitted in our hospital between February 2015 and February 2016 were collected. The characteristics of CT and MRI images were analyzed. Results In 48 patients with bilateral frontoparietal subdural hemorrhage, 20 cases underwent CT scan, including 7 cases in acute phase, 11 cases in subacute phase and 2 cases in chronic phase, 28 cases underwent MRI scan, including 11 cases in acute phase, 10 cases m subacute phase and 7 cases in chronic phase. CT plain scan of patients with bilateral frontoparietal subdural hemorrhage showed arc equal and low density shadow below bilateral frontoparietal skull inner plate, clear hematoma, with bone artifacts and no abnormality of brain parencbyma. MRI axial scan T1 showed high density shadow below bilateral frontoparietal skull inner plate, and the adjacent brain parenchyma was slightly pushed; There was no abnormal signal in brain parenchyma, and gray matter interface was clear. Some sulus broadened and deepened while gyri became shallow, The midline structures were without deviation. MR1 axial scan T2 showed that there was high density shadow below bilateral frontoparietal skull inner plate, and there were no abnormal basicrauial vascular shape and lost shape. The signal of skull bone marrow was normal. MRI axial scan FLAIR showed bilateral high signal shadow below bilateral frontoparietal skull inner plate. EDWI showed no diffusion limitation. Conclusion CT scan can show equal and low density shadow below bilateral frontoparietal skull inner plate and unclear hematoma; MRI axial scan T1 shows arc high signal shadow, clear hematoma, midline structure without shift. Axial T2 shows arc high signal shadow, and axial FLAIR shows arc high signal shadow. EDWI shows no diffusion limitation. The CT and MRI findings of bilateral frontoparietal subdural hemorrhage are clear. In clinic, examination should be based on MRI, and CT can be used as a complementary examination.