摘要
目的评价磁敏感加权成像（SWI）对弥漫性轴索损伤（DAI）诊断及其与格拉斯哥昏迷（GCS）评分相关性分析的临床应用价值。方法对经临床诊断为DAI并行MRI检查的24例患者,行常规MRI（T1WI、T2WI、FLAIR、DWI）及SWI扫描,比较DAI病灶的显示率并分析其信号特征,评价SWI在DAI诊断中的价值及其与GCS评分的关系。结果 24例DAI病灶主要分布在皮髓质交界区、脑白质区、基底节区、胼胝体、脑干及小脑。常规序列检出DAI病灶37个,T1WI、T2WI序列病灶呈点状或小结节状,信号表现多样。SWI序列检出DAI病灶179个,病灶呈斑点状、串珠状或线条状明显高、低或高低混杂信号。18例未累及脑中线结构,6例累及脑中线结构。24例中GCS评分轻度（13-15分）13例,中度（9-12分）6例,重度（3-8分）5例;治愈9例,好转9例,植物状态4例,死亡2例。结论 DAI病灶数目多、分布广泛或累及脑中线结构者,GCS评分低,二者均有明显相关性。SWI对DAI病灶的检出具有较高的敏感性,能较常规MRI序列检出更多的脑内微小出血灶,为临床早期诊断和治疗方案的制订及评估预后提供重要依据。
Objective To evaluate the clinical application value of susceptibility weighted imaging（SWI）in diagnosis of diffuse axonal injury（DAI）and to investigate its correlation with Glasgow coma score（GCS）.Methods 24 patients with clinically diagnosed DAI were performed the conventional MRI including T1 WI,T2WI,FLAIR,DWI and SWI scanning.The demonstration rate of DAI lesions was compared and its signal characteristics were analyzed.The value of SWI in the diagnosis and the GCS score was evaluated.Results The DAI lesions in this group were located in the corticomedullary junction area,white matter area,basal ganglia area,corpus callosum,brain stem and cerebellum.37 DAI lesions were detected by the conventional MR sequence scanning,T1 WI and T2 WI sequence lesions showed dot-like or nodule-like with various signal manifestations,while 179 DAI lesions were detected by SWI sequence,which showed spot-like,bead-like or line-like with apparent high,low or high-low mixed signals.18 cases did not involved the brain central line structure and 6cases were involved the brain central line structure.Among 24 cases,13cases were mild GCS scores（13-15）,6cases were moderate GCS scores（9-12）and 5cases were severe GCS scores（3-8）;9cases were cured,9cases were improved,4cases showed a state of plant and 2cases died.Conclusion The DAI patients with many lesions,wider distribution or involving brain central line structure got lower GCS score,there is obvious correlation between them.SWI has higher sensitivity for detecting DAI lesion and can detect more intracerebral micro bleeding lesions than the conventional MRI sequence,which can provide the important basis for clinically early diagnosis,formulating the treatment scheme and evaluating the prognosis.
出处
《检验医学与临床》
CAS
2015年第22期3334-3336,共3页
Laboratory Medicine and Clinic
基金
重庆市渝北区社会事业科技项目
