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目的 观察脑梗塞发病 2 4h内的CT表现并通过再次阅片加强寻找低密度及脑梗塞其他早期CT征象 ,总结经验以提高早期脑梗塞CT诊断水平。方法 先查阅脑梗塞病历及CT报告 ,找出发病 2 4h内行首次CT检查者 ,记录其CT结果 ,然后复阅存档CT资料 ,比较两次阅片结果。结果 脑梗塞患者 2 4h内CT初、复阅阳性率分别为 64.5 %和 82 .7% ,正确诊断率为 5 5 .3%和 64.4 % ,定位诊断符合率为 85 .7%和77.3%。早期脑梗塞最常见的CT征象为低密度改变 ,其在脑梗塞 2 4h内的发生率初、复阅分别为 64.4 %和73.1% ,正确诊断率为 5 5 .7%和 5 4 .8%。复阅时发现其他早期脑梗塞征 4 6例次 ,定位诊断符合率 78.3%。结论 脑硬塞发病 2 4h内头部CT检查有 5 0 %以上的病人可获确诊 ,诊断主要依据脑实质低密度改变 ,早期征象包括动脉高密度征、占位征、豆状核或皮质结构模糊均有参考意义
Objective To observe the CT manifestations within 24 hours of onset of cerebral infarction and to seek further low-density and early CT signs of cerebral infarction by re-reading, and to sum up experience to improve the CT diagnosis of early cerebral infarction. Methods First consult the cerebral infarction medical records and CT reports to identify the first 24 h onset line CT examination of the first, record the CT results, and then review the archived CT data, compare the results of two readings. Results The positive rates of initial and review of CT in 24 h were 64.5% and 82.7% respectively in patients with cerebral infarction. The correct diagnosis rates were 55.3% and 64.4%. The coincidence rates of positioning diagnosis were 85.7% and 77.3% respectively. The most common CT signs of early cerebral infarction were low-density changes. The incidence of early-onset cerebral infarction within 24 hours was 64.4% and 73.1% respectively. The correct diagnosis rates were 55.7% and 54.8% . During the review, other early cerebral infarcts were found in 46 cases, and the coincidence rate was 78.3%. Conclusion Fifty percent of patients with head CT were diagnosed within 24 hours after onset of cerebral cortex. The diagnosis mainly depends on the low density of brain parenchyma. The early signs include arterial high density sign, occupancy sign, lenticular nucleus or cortical structure Fuzzy have reference value