颅内等密度病变的CT诊断与鉴别诊断

CT Diagnosis and Differential Diagnosis of Intracranial Lesions with Isodense

目的:探讨颅内等密度病变的CT诊断与鉴别诊断。方法:对39例经手术证实或随访证实的CT平扫为等密度病变进行回顾性分析。结果:39例中,按照病种来分,胶质瘤8例,脑膜瘤6例,转移瘤4例,听神经瘤2例,脑血管畸形3例,垂体瘤2例,硬膜外血肿5例,硬膜下血肿6例,脑脓肿2例,脑梗死1例。按照CT征象来分,临近脑质密度改变11例,临近脑质推移17例,脑室受压10例,脑沟增宽2例,脑沟变窄23例,中线结构移位8例,骨质改变10例,病灶内钙化6例,脑水肿14例,脑积水2例。CT增强扫描病变呈现疾病本身常见的典型征象。结论:颅内等密度病变通过CT平扫不容易发现,CT诊断医师需仔细分析CT图像表现并进行推断,CT增强扫描有助于协助诊断。

Objective:To investigate the CT diagnosis and differential diagnosis of intracranial lesions with isodense.Methods:39 cases were retrospectively analyzed with CT plain scan confirmed by operation or follow-up.Results:Among the 39 cases,according to the lesion,included glioma(n=8),meningioma(n=6),metastatic tumor(n=4),acoustic neuroma(n=2),cerebrovascular malformation(n=3),pituitary tumor(n=2),epidural hematoma(n=5),subdural hematoma(n=6),brain abscess(n=2),cerebral infarction(n=1).According to the CT signs,there were 11 cases of adjacent brain density changes,17 cases of adjacent brain mass movement,10 cases of ventricular compression,2 cases of widening of the sulcus,23 cases of narrowing of the sulcus,8 cases of midline structure shift,10 cases of bone change,6 cases of calcification in the lesion,14 cases of cerebral edema and 2 cases of hydrocephalus.CT enhanced scan showed the typical signs of the disease itself.Conclusion:Intracranial lesions with isodence are not easy to find by CT plain scan,CT diagnostic doctors need to carefully analyze the CT image performance and infer,and CT enhanced scanning is helpful to assist the diagnosis.