Evaluation Of Superior Sagittal Sinus Compression After Cranial Top Trauma By CT Angiography And Its Clinical Prognostic Value

Part 1: Feasibility study of CT angiography showing superior sagittal sinusObjective : To investigate the ability and advantage of 64-slice spiral CT angiography in the superior sagittal sinusMethods:115 cases of traumatic patients with conventional cranial top trauma CT angiography were enrolled from January 2015 to December 2016,aged from 16 to 77 years,99 males and 16 females.All patients were treated with 64 rows of 128-slice spiral CT.The threshold was set to 120 HU,and the high-pressure syringe was injected intravenously through the middle of the elbow.Ionic contrast agent(370mg/ml)70~90ml,injection rate of 4 ~ 5ml/s.The collected thin layer data were reconstructed using the ADW4.4 post-processing software to obtain an angiographic image,and the image quality was scored by two senior imaging diagnostic physicians.Results:All 115 patients underwent CT angiography.Two physicians evaluated the arterial display quality,and the superiority of the superior sagittal sinus showed satisfactory results(Kappa > 0.75),the difference was not statistically significant.The average pass rate of the artery was 100%,the excellent and good rate was 98.7%.The superior rate of the superior sagittal sinus was 96.6% and the excellent and good rate was86.6%.Conclusion:64-MSCT angiography can display arterial and superior sagittal sinus in one scan at the same time.The image quality meets the clinical diagnosis needs.Part II: Clinical application of CT angiography in the assessment of superior sagittal sinus compression after cranial top trauma Objective:To evaluate the clinical value of CT angiography in the early diagnosis ofsuperior sagittal sinus compression by analyzing the risk factors of prognosis in 38 patients with cranial top trauma.Methods:A total of 388 cases of traumatic cases with angiography were performed with 64-slice spiral CT from June 2010 to November 2016.38 patients with traumatic cranial top trauma were analyzed and summarized the main imaging findings.,Age,upper sagittal sinus compression,skull fracture,epidural hematoma,subdural hematoma as independent variables and poor prognosis as the dependent variable.Logistic stepwise regression method was used to establish the optimal regression equation for predicting the prognosis of patients with cranial top trauma,Screening the main risk factors affecting prognosis and analysis of its causes.Results:(1)Gender,age,skull fracture,epidural hematoma and subdural hematoma and traumatic head injury were not significantly different between the occurrence of poor prognosis(P> 0.05);(2)Only the superior sagittal sinus was screened into the Logistic regression equation after regression analysis,indicating a significant association between poor prognosis and traumatic malformations;(3)There was significant difference between the different sagittal sinus compression and the prognosis of patients with cranial top trauma.(P <0.05).Conclusion :(1)skull fracture,epidural hematoma and subdural hematoma and traumatic head injury can cause superior sagittal sinus compression;(2)The superior sagittal sinus compression or occlusion is the main risk factor of poor prognosis in patients with cranial top trauma.The reason is that it plays an important role in the regulation of intracranial pressure,the maintenance of cerebral blood circulation and blood supply stability;(3)early traumatic brain injury in patients with CT angiography to diagnose whether the superior sagittal sinus for its prognosis is very important to determine the prognosis.