磁共振多b值扩散加权成像对肢体高压电击伤预后的预测

目的探讨磁共振成像(magnetic resonance imaging,MRI)多b值扩散加权成像(diffusion weighted imaging,DWI)对肢体高压电击伤预后的预测价值。方法选取2015年9月~2018年12月在本院诊治的肢体高压电击伤患者76例,所有患者都给予常规MRI与多b值(b值=0、100、400、800、1200 s/mm2)DWI扫描,记录成像特征与成像参数指标,判断预测预后价值。结果健侧与患侧的MRI图像质量优良率皆为100%,符合诊断要求,损伤部位多呈现等T1或稍长T1信号,稍长T2信号。在76例中患侧多b值DWI的D*值、f值都显著高于健侧,而D值显著低于健侧,对比差异有统计学意义(P<0.05)。病理判断为损伤组织完全坏死38例,部分坏死30例,水肿8例。MRI诊断为完全坏死39例,部分坏死31例,水肿6例,MRI诊断的准确性为93.4%。结论MRI多b值DWI能清晰显示肢体高压电击伤的组织坏死情况,也能真实反映组织的扩散特性,能有效预测患者的预后。

Prediction of prognosis of limb high voltage electric shock based on magnetic resonance and multi-b value diffusion weighted imaging

Objective To investigate the predictive value of magnetic resonance imaging(MRI)multi-b diffusion weighted imaging(DWI)for the prognosis of limb high voltage electric shock.Methods From September 2015 to December 2018,76 patients with limb high voltage electric shock were selected and treated in our hospital.All patients were given conventional MRI and multiple b values(b value=0,100,400,800,1200 s/mm2)DWI scan,recorded the imaging features and imaging parameters,and were to judge the prognostic values.Results The excellent and good MRI images of the healthy side and the ill side were 100.0%,which met the diagnostic requirements.The ill side was showed more T1 or slightly longer T1 signal and slightly longer T2 signal.In the 76 patients,the D*and f values of the multi-b value DWI on the ill side were significantly higher than those on the healthy side,while the D value were significantly lower than the healthy side that compared the difference were statistically significant(P<0.05).Pathological judgment showed there were 38 patients of complete necrosis of damaged tissue,30 patients of partial necrosis and 8 patients of edema.MRI diagnosed as complete necrosis in 39 patients,partial necrosis in 31 patients,and edema in 6 patients,so that the accuracy of MRI diagnosis was 93.4%.Conclusion MRI multi-b value DWI can clearly show the tissue necrosis of limb high voltage electric shock,which can also truly reflect the tissue diffusion characteristics,and effectively predict the prognosis of patients.