Drayer B P, Rosenbaum A E
J Comput Assist Tomogr. 1979 Jun;3(3):317-23. doi: 10.1097/00004728-197906000-00003.
Cranial computed tomography permitted an in vivo classification of brain edema. The distinction of the four basic types of edema (vasogenic, ischemic, cytotoxic, and periventricular) was important in establishing the chronicity, extent, and pathologic basis of cerebral abnormalities. Vasogenic edema (neoplasm, abscess) was readily distinguished from cytotoxic edema by the predominant involvement of the white matter and associated abnormal enhancement following intravenous contrast medium injection. The diminished density of ischemic edema was visualized in both gray and white matter and occurred in a vascular distribution. An absence of enhancement in the cerebral capillary bed and attenuation or nonvisualization of the circle of Willis following the rapid bolus injection of iodinated contrast medium defined an arrest of cerebral circulation as might be seen in brain death. Periventricular interstitial edema was most often a marker of acute or subacute obstructive hydrocephalus.
头颅计算机断层扫描可对脑水肿进行活体分类。区分四种基本类型的水肿（血管源性、缺血性、细胞毒性和脑室周围性）对于确定脑部异常的慢性程度、范围及病理基础很重要。血管源性水肿（肿瘤、脓肿）通过主要累及白质以及静脉注射造影剂后出现相关异常强化，很容易与细胞毒性水肿区分开来。缺血性水肿在灰质和白质中均可见密度减低，且呈血管分布。快速团注碘化造影剂后，脑毛细血管床无强化以及 Willis 环衰减或未显影，表明存在脑循环停止，这在脑死亡时可见。脑室周围间质性水肿最常是急性或亚急性梗阻性脑积水的一个标志。
