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1、硬膜外血肿的影像诊断Imaging Diagnosis of Epidural Hematoma 昆明医学院第三附属医院放射科谭静,目的（objective）,1、掌握硬膜外血肿的CT及MRI诊断。Master the CT and MRI diagnosis of the Epidural Hematoma.2、掌握硬膜外血肿影像检查方法的选择。Master the choice of imaging method in Epidural Hematoma.,一、定义（Definition）,一、定义（Definition）颅内出血积聚于颅骨与硬膜之间称为硬膜外血肿。Epidural hem
2、atoma is an extra blood collection,located between the dura and the inner table of the skull.,硬膜,颅骨,血肿,二、临床表现（Clinical Findings）,二、临床表现（Clinical Findings）临床出现头痛、呕吐、昏迷等症状，严重者出现脑疝。Clinical manifestations include headache、vomit、coma，in severe case appear hernia of brain.,三、影像诊断（Imaging Diagnosis)X线诊断 C
3、T诊断 MRI诊断,1、X线诊断（X-ray Diagnosis)仅能显示颅骨骨折，诊断价值有限。,血肿,脑,颅骨,2、CT及MRI诊断(CT and MRI Diagnosis),2、CT及MRI诊断(CT and MRI Diagnosis)双凸形血肿 biconvex hematoma,双凸形血肿 Biconvex Hematoma,CT,双凸形血肿 biconvex hematoma,MRI T1WI,2、CT及MRI诊断(CT and MRI Diagnosis)双凸形血肿 Biconvex Hematoma 颅骨骨折 Skull Fracture,脑窗Cerebral window
4、,CT,颅骨骨折 Skull Fracture,骨窗Bone Window,CT,颅骨骨折 Skull Fracture,脑窗Cerebral Window,骨窗Bone Window,CT,2、CT及MRI诊断(CT and MRI Diagnosis)双凸形血肿 Biconvex Hematoma 颅骨骨折 Skull Fracture 占位效应 Mass Effect,占位效应 Mass Effect,CT,占位效应 Mass Effect,MRI T1WI 冠状,2、CT及MRI诊断(CT and MRI Diagnosis)双凸形血肿 Biconvex Hematoma 颅骨骨折 S
5、kull Fracture 占位效应 Mass Effect 头皮软组织肿胀 Scalp Soft Tissue Swelling,头皮软组织肿胀 Scalp Soft Tissue Swelling,CT,头皮软组织肿胀 Scalp Soft Tissue Swelling,MRI T2WI 矢状,我们还能为临床提供更多的诊断信息吗？,答案是肯定的！,血肿在不同时期的表现,急性期血肿,CT MRI T1WI MRI T2WI,亚急性期血肿,CT MRI T1WI MRI T2WI,慢性期血肿,CT MRI T1WI MRI T2WI,血肿在不同时期的表现,3、影像方法的选择(choice o
6、f imaging modalities)CT是最主要的检查方法。对于亚急性期和慢性期的血肿，MRI的显示优于CT。CT is the main inspection method,MRI showed better than CT in hematoma in subacute phase and chronic phase.,MRI DWI,四、鉴别诊断（Differential Diagnosis）与硬膜下血肿鉴别 血肿的形状。(The shape of the hematoma.)是否跨越中线或颅缝。(Whether the cranial seam or midline across
7、.),硬膜外血肿 硬膜下血肿,CT,硬膜外血肿 硬膜下血肿,MRI T2WI,五、小结（Brief Summary）双凸形 Biconvex 骨折 Fracture 移位 Shift 肿胀 Swelling,重点词汇（Key Words）硬膜外血肿 Epidural Hematoma 颅骨骨折 Skull Fracture 脑窗 Cerebral Window 骨窗 Bone Window 占位效应 Mass Effect,If the hematoma happened in cerebral,what typical image sign will be shown?,参考书籍脑与脊髓CT及MRI诊断学图谱主编李联忠，人民卫生出版社,2009年9月中枢神经系统CT和MRI诊断主编沈天真，上海医科大学出版社,2006年1月 CT Clinical Applications,and Quality Control Euclid seemram RT(R)BSc MSC,2010 CT and MRI of the Whole Body John R.Haaga MD,2010,谢谢！,
