脑弥漫性轴索损伤的临床表现及CT诊断价值

目的:探讨脑弥漫性轴索损伤的临床特点及CT表现特征,评价CT诊断它的价值。方法:对32例脑弥漫性轴索损伤患者的临床资料及CT表现进行回顾性分析。结果:根据格拉斯哥昏迷评分(GCS):轻度昏迷2例,中度昏迷10例,重度昏迷20例。23例见弥漫性脑肿胀,大脑半球皮髓质交界处小出血灶16例(直径<2cm),脑干小出血灶7例,胼胝体出血灶3例,脑池及蛛网膜下腔出血9例,脑室出血4例,脑室、脑池普遍受压变小、消失2例,中线移位13例,单一病灶损伤5例,多处病灶损伤27例。结论:脑弥漫性轴索损伤是临床上常见的颅脑损伤类型,其病情急,症状重,病死率高。诊断主要根据临床和影像学表现,CT具有特异性,是诊断脑弥漫性轴索损伤的重要方法。

Study on the clinical manifestations and CT diagnostic value of diffuse axonal injury

Objective: to explore the clinical characteristics and CT performance characteristics of diffuse axonal injury(DAI),and evaluate the diagnostic value of CT in diffuse axonal injury.Methods: Clinical data and CT manifestations of 32 case DAI were retrospectively analyzed.Results: The prognosis of the patients was grouped according to Glasgow coma scale(GCS): 2 cases were mild coma,10 cases were moderate coma,and 20 cases was severe coma.Diffuse cerebral swellings was found in 23 cases,small hemorrhage lesions at the cortex-medulla junction in 16 cases(diameter <2 cm),small hemorrhage lesions at the brainstem in 7 cases,the corpus callosum hemorrhage lesions in 3 cases,cisternal and subarachnoid hemorrhage lesions in 9 cases,ventricle hemorrhage lesions in 4 cases,general compression or disappearance of ventricle and cistern in 2 cases,midline shift in 13 cases,a single lesion in 5 cases,multiple lesions in 27 cases.Conclusion: Diffuse axonal injury,a common type of head injury,is a cute and severe disease with high mortality.The diagnosis of DAI is mainly based on clinical and image characteristics such as specific confirmation of the CT diagnosis.