Significance of computed tomography mixed density in traumatic extra-axial hemorrhage
Significance of computed tomography mixed density in traumatic extra-axial hemorrhage
复制标题
DOI：
10.1179/016164102101199657
复制
发表时间：
2002-03-01
影响因子：
1.9
通讯作者：
Michael, DB
中科院分区：
文献类型：
--
作者：
Subramanian, SK;Roszler, MH;Michael, DB
据报道，计算机断层扫描（CT）显示外伤性轴外出血（TEN）的混合密度或“漩涡征”与开颅时发现的活动性出血和不良预后相关。本研究旨在验证第三代或第四代CT检测到的TEH混合密度与出血类型或临床结果相关的假设。1991-1997年在底特律接收医院手术的所有TEH病例的出血类型（活动性与非活动性；动脉与静脉）进行了回顾；格拉斯哥昏迷评分（严重1-8分，不严重9-15分）；格拉斯哥预后评分（1-3差，4 - 5好）。然后对51例有特定出血类型书面记录的病例进行CT密度（CTD）独立检查（SKS和MHR），并将其分为混合或高密度TEH。数据分析采用校正卡方分析、Fischer精确检验和Pearson相关分析（SPSS 6.0）。相关性的Pearson χ 2概率如下：CTD vs活动性出血，0.21；CTD vs动脉，0.41；CTD vs严重性，0.57；CTD与预后的比值为0.81。没有其他统计分析发现显著的相关性，因此零假设不能被拒绝。CT混合密度与出血类型、损伤严重程度及预后无明显相关性。外科医生对出血类型的不准确记录和使用新一代CT可能导致本研究与以往研究之间的差异。然而，我们得出结论，临床检查和其他公布的CT标准是损伤严重程度和结果的更好指标。
Computed tomography (CT) mixed density of traumatic extra-axial hemorrhages (TEN) or the 'swirl sign' has been reported to correlate with active bleeding found at craniotomy and poor outcome. This study was done to test the hypothesis that mixed density of TEH detected by third or fourth generation CT correlated with the type of bleeding or clinical outcome. All cases of TEH operated at Detroit Receiving Hospital from 1991-1997 were reviewed for type of bleeding (active vs. not active; arterial vs. venous); Glasgow Coma Scale (severe 1-8, not severe 9-15); and Glasgow Outcome Score (1-3 poor; 4,5 good). CT density (CTD) of 51 cases with specific written documentation of bleeding type were then independently reviewed (SKS and MHR) and classified into TEH with mixed or high density. Data was analyzed using corrected Chi Square analysis, Fischer's Exact Test and Pearson's Correlation (SPSS 6.0). The Pearson Chi Square probability for correlation follows: CTD vs. active bleeding, 0.21; CTD vs. arterial, 0.41; CTD vs. severity, 0.57; and CTD vs. outcome, 0.81. No other statistical analysis identified a significant correlation, thus the null hypothesis could not be rejected. CT mixed density was not found to be correlated by more than chance with bleeding type, injury severity or outcome. Surgeon inaccuracy in documentation of bleeding type and use of later generation CT may account for the discrepancy between this and previous studies. Nevertheless, we conclude clinical exam and other published CT criteria are better indicators of injury severity and outcome.