使用CT静脉扫描对持续静脉鼻的创伤性损伤的分类
Daniel A Schwartz1,2, Jason Talbott3, Andrew Callen3,4
1Department of Neurology, School of Medicine, University of California San Francisco, San Francisco, California, USA.
概括
创伤性脑静脉鼻损伤 (CVST) 的新分级系统在诊断创伤性脑损伤 (TBI) 中显示了中度至实质性的可靠性. 压力损伤比血栓形成更为常见,有助于治疗决策.
科学领域:
- 放射学 放射学是一门学科.
- 神经学 神经学
- 创伤外科 手术 创伤外科
背景情况:
- 大脑静脉鼻血栓塞 (CVST) 是急性创伤性脑损伤 (TBI) 患病的重要原因.
- 在TBI中CVST的放射性诊断是具有挑战性的,因为同时发生的伤害和缺乏标准化的标准.
- 创伤性血栓和静脉压缩之间的区别,对于治疗至关重要,仍然不清楚.
研究的目的:
- 开发和验证创伤性CVST的标准化放射学分级方法.
- 在TBI患者中区分压力和血栓静脉损伤.
- 评估拟议的分级系统的可靠性.
主要方法:
- 基于基于流量限制和静脉病理的位置 (压缩与血栓形成) 的两部分分级系统被开发出来,使用CT静脉谱.
- 该系统在1级创伤中心对TBI患者进行了追溯应用.
- 评价者之间的可靠性由高级神经放射学家评估.
主要成果:
- 总共包括了76名创伤性静脉鼻损伤的TBI患者.
- 用七个等级来描述静脉损伤,压力损伤更常见 (43.4%).
- 评分系统显示了中等至实质性的评分器间可靠性 (kappa = 0.48用于组合等级,kappa = 0.69用于流量限制).
结论:
- 引入了创伤性静脉鼻损伤的标准化两部分分类系统.
- 该系统表现出中等至实质性的评级者间可靠性.
- 在这个群体中,压力损伤比血栓损伤更为普遍,因此需要进一步验证临床意义.
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