创伤性颅脑损伤患者CT征象及预后分析

CT Imaging Findings and Prognostic Value in Patients with Traumatic Brain Injury

目的研究创伤性颅脑损伤患者CT征象及对其预后评估价值。方法回顾性分析我院2015年3月至2018年3月收治创伤性颅脑损伤患者168例,并根据患者创伤后3月格拉斯哥预后量表(GOS)评分将其分为预后良好组(评分为4-5分)126例和预后不良组(评分为1-3分)42例。所有患者均使用64排螺旋CT检查,对所有患者CT征象(三脑室形态、侧脑室受压、中线位移及环池变化)进行统计,并分析CT征象与预后之间关系。结果共168例创伤性颅脑损伤患者中三脑室宽径6-10mm患者最多为74例(44.05%),侧脑室受压比例>0.2患者最多为89例(52.98%),中线位移6-10mm患者最多为72例(42.86%),环池宽度2-3mm患者最多为81例(48.21%)。影响创伤性颅脑损伤患者GOS预后评分单因素有:三脑室宽径、侧脑室受压比例、中线位移、环池宽度(P<0.05);影响创伤性颅脑损伤患者GOS预后评分不良的多因素有:三脑室宽径在6-10mm、中线位移>10mm、环池宽度0-1mm(P<0.05)。结论CT征象对创伤性颅脑损伤程度有一定提示作用,且三脑室宽径、侧脑室受压比例、环池宽度可在一定程度预测患者预后,可为患者临床治疗及后期恢复提供参考依据。

Objective To study the CT imaging findings of patients with traumatic brain injury and to evaluate and analyze the prognostic value.Methods A total of 168 cases of patients with traumatic brain injury from March 2015 to March 2018 in our hospital were analyzed retrospectively and were divided into good prognostic group(score from 4 to 5points,126 cases)and poor prognostic group(score from 1 to 3 points,42 cases)according to the Glasgow Outcome Scale(GOS)score at 3 months after trauma.All patients were given 64-slice spiral CT examination,analyze the CT findings of third ventricle morphology,lateral ventricle compression,midline displacement and cisterna changes,and to analyze the relationship between these CT findings and the prognosis.Results Among168 patients with traumatic brain injury,there were 74 cases(44.05%)of patients with a widened third ventricle of 6-10 mm,and there were 89 cases(52.98%)of lateral ventricle compression more than 0.2,and there were 72 cases(42.86%)patients with midline displacement from 6-10 mm,and there were 81 cases(48.21%)of patients with cisterna width of 2 to 3 mm.The single factors affecting the GOS prognosis score in patients with traumatic brain injury were the width of third ventricle,proportion of lateral ventricle compression,midline displacement and cisterna width(P<0.05).The multiple factors affecting GOS prognosis scores in patients with traumatic brain injury were the width of third ventricle from 6 to 10mm,midline displacement>10mm and cisterna width from 0to 1mm(P<0.05).Conclusion CT signs have a certain role in suggesting the condition of patients with traumatic brain injury,and the width of the third ventricle,the compression ratio of lateral ventricle and the width of cistern can predict the prognosis of patients to a certain extent,which can provide a reference basis for clinical treatment and later recovery of patients.