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目的回顾性评估应用平行于颅骨内板的曲面最大强度投影(MIP)对颅内血肿的检出率并与仅读取CT横断面影像的检出率进行比较。材料与方法本项回顾性研究经机构审查委员会批准,并免除知情同意书。连续选取314例头颅外伤并行CT检查的病例[男155例,女159例;年龄2～98岁,平均(58±24)岁]。该算法将每例病人的脑膜间隙展开为4幅影像。4名放射科医师独立地对所有病例进行评估。厚度<3mm的血肿被定义为薄血肿。在不知晓病人名字的前提下,将病人随机分组并排序。结果与2位专家建立的参考标准进行比较。采用重复测量的逻辑回归进行统计分析。结果应用上述参考标准确定了39例病人的121处颅内血肿。对于所有观察者,应用曲面MIP检测血肿的阅片时间明显更少(减少3～5倍,P<0.001)。所有阅片者应用横断位影像和曲面MIP的病变平均检出率分别为80%(193/242)和83%(200/242)。对于薄血肿,阅读MIP的平均检出率较应用横断位明显提高,由20%(8/40)提高到83%(33/40)。结论脑膜间隙的曲面MIP可以缩短硬膜外和硬膜下血肿的诊断时间,增加敏感性(尤其对薄血肿),并减少对检测者经验的要求。
Objective To retrospectively evaluate the detection rate of intracranial hematoma using maximum intensity projection (MIP) parallel to the skull plate and to compare the detection rate of CT cross-sectional images only. Materials and Methods This retrospective study was approved by an institutional review board and exempted from informed consent. A total of 314 cases of craniocerebral trauma concurrent CT examination were selected continuously [155 males and 159 females; mean age (58 ± 24) years), ranging in age from 2 to 98 years. The algorithm expands each patient’s meningeal space into four images. Four radiologists independently evaluated all cases. A hematoma of <3 mm in thickness is defined as a thin hematoma. Without knowing the name of the patient, patients were randomized and sorted. The results were compared with the reference standards established by two experts. Statistical regression was performed using logistic regression with repeated measures. Results The above reference standard was used to determine 121 intracranial hematomas in 39 patients. For all observers, there was significantly less time to read the hematoma using the MIP surface detection (3 to 5-fold reduction, P <0.001). The mean lesion detection rates of all scanners using transverse and MIP images were 80% (193/242) and 83% (200/242), respectively. For thin hematoma, the average read rate of MIP reading was significantly increased from 20% (8/40) to 83% (33/40) as compared with the application of transection. Conclusions MIP of meningeal space can shorten the diagnosis time of epidural and subdural hematoma, increase the sensitivity (especially for thin hematoma), and reduce the experience of the examiner.