外部性脑积水的CT诊断及临床应用价值

CT Diagnosis and Clinical Application Evaluation of External Hydrocephalus

目的:探讨外部性脑积水(EH)的CT特征及临床应用价值。材料与方法:回顾分析临床资料完整的66例外部性脑积水的CT表现及测量脑室颅腔横径(VT/ST)率。结果:特发性者34例(51.52％),32例继发性主要原因为缺氧缺血性脑病,为18例(占56.25％)。EH的CT特征为:大脑半球叶间裂前部增宽(大于等于6mm),额顶区蛛网膜下腔对称性增宽(大于等于5mm),可伴额顶区脑沟回增宽加深,严重者可伴双侧侧裂池增宽及鞍上池增大,脑室不扩大或仅轻度扩大,VT/ST率小于15％。结论:根据患儿短期内有头围异常增大,前囱膨隆,抽搐以及特有的CT表现,对EH的诊断并不困难,CT检查对EH的临床诊断、病程观察及指导治疗具有重要价值。

Purpose To investigate the CT feature and clinical application evaluation of external hydrocephalus (EH). Materials and Methods The CT findings in 66 cases of EH associated with intact clinical data were retrospectively analyzed. The transveral diameter ratio of ventricular to skull (VT/ST) was measured in all cases. Results In the 66 cases, 34 case was idiopathic and the other cases was secondary. There were 32 cases that the main etiological factor was hypoxic-ischemic encephalopathy (HIE) in the secondary cases. The characteristic CT findings in EH were as follows: (1) Widening of the subarachnoid space in the bifrontoparietal regions,(2)Widening of the interhemispheric fissure frontally, (3)Widening and deepening sulcus and gyrus in the bifrontoparietal regions in some cases,(4) Widening and enlargement of the cistern of bi-lateral fossa and suprasellar cistern in the severity cases,(5)Without enlargement or with only mild enlargement of the cerebral ventricle.(6)The VT/ST ratio was lower than 15 %. Conclusion Combining the characteristic CT findings with the correlated clinical feature, such as enlargement of the head circumference in short period and expanded anterior fontanelle and tic, the EH diagnosis is not difficult. CT is one of the optimal techniques in diagnosing EH and the outcome of the treatment and the clinical treat. CT had the important applied value.