硬膜下血肿的类似表现。
Subdural haematoma mimics.
机构信息
Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
出版信息
Clin Radiol. 2019 Sep;74(9):663-675. doi: 10.1016/j.crad.2019.04.013. Epub 2019 May 17.
A subdural haematoma (SDH) is a frequently encountered pathology seen on an emergency room computed tomography (CT) head scan. An extra-axial crescentic density along the convexity of the brain or within the interhemispheric fissure is generally thought to represent a SDH; however, SDH mimics are known to occur in nature, and can be broadly classified under the subcategories of normal anatomy, artefacts, tumour, inflammation, infection, ischaemia, trauma, and iatrogenic. Understanding the typical characteristics of a SDH, knowledge of normal anatomy, close inspection of the morphology of the subdural process, changes to the adjacent structures, and rigorous attention to clinical details may reveal subtle clues that distinguish a true SDH from a mimic. This is crucial in appropriately directing clinical management. This review amalgamates most of the rare subdural processes that have been reported to mimic SDH, and discusses the imaging and clinical features that help to differentiate between them. This topic is highly valuable for radiology trainees, general radiologists, and emergency room physicians, and may serve as a refresher for the practising neuroradiologist.
硬膜下血肿(SDH)是急诊科计算机断层扫描(CT)头部扫描中常见的病理表现。大脑凸面或大脑半球间裂内沿脑外的新月形密度通常被认为代表 SDH;然而,已知 SDH 模拟物在自然界中存在,并且可以广泛分为正常解剖、伪影、肿瘤、炎症、感染、缺血、创伤和医源性等亚类。了解 SDH 的典型特征、正常解剖知识、仔细观察硬膜下过程的形态、邻近结构的变化以及严格关注临床细节,可能会发现细微线索,将真正的 SDH 与模拟物区分开来。这对于正确指导临床管理至关重要。本综述综合了大多数已报道的硬膜下过程模拟 SDH 的罕见病例,并讨论了有助于区分它们的影像学和临床特征。这个话题对放射科医师、普通放射科医师和急诊医师非常有价值,也可以作为神经放射科医生的复习资料。