DWI联合SWI诊断脑外伤后微病灶的临床价值

目的探讨弥散加权成像（DWI）联合磁敏感成像（SWI）诊断脑外伤后微病灶的价值。方法收集并分析经临床和影像证实的18例脑外伤后微病灶患者的MRI检查资料,所有患者均在常规扫描的基础上进行扩散加权及磁敏感成像检查。结果 18例患者中微梗死5例,脑挫裂伤的微出血17例（其中弥漫性轴索损伤5例）;微出血急性期病灶在DWI序列上呈高信号,在ADC图上呈低信号,随后DWI信号降低,ADC信号则相应由低信号转变为高信号,SWI系列上则一直为低信号;微脑梗死病灶在DWI序列上呈高信号,在ADC图上呈低信号,SWI呈稍高信号。结论脑外伤微病灶在DWI及SWI序列上有特征性表现,应作为脑外伤后患者的常规检查。

Clinical value of DWI combined with SWI in diagnosis of micro-lesions after cerebral trauma

Objective To explore the diagnostic value of DWI combined with SWI for micro lesions after cerebral trauma. Methods The data of 18 cases were collected and analyzed, which were diagnosed by clinical manifestations and imaging and underwent conventional scanning of DWI and SWI. Results Among 18 patients, there were 5 cases with micro-infarction, 17 cases with micro-bleeding and contusion and laceration（5 cases with diffuse axonal injury）. On DWI sequence, micro hemorrhage lesions of brain trauma showed high signal, but on ADC, it showed low signal. Then, DWI signal decreased slightly, and the ADC signal went up slowly, but on SWI sequence, it showed low signal at all the time. Micro cerebral lesions showed high signal on DWI sequence, low signal on ADC maps and moderate signal on SWI. Conclusion DWI and SWI showed characteristic manifestations in micro-lesions after cerebral trauma, which should be used as a routine examination in patients with post-traumatic brain injury.