CT与MRI在弥漫性颅脑轴索损伤诊断中的应用价值评价

目的比较计算机断层扫描(CT)与磁共振成像(MRI)在弥漫性颅脑轴索损伤(DAI)临床诊断中的价值。方法采用回顾性研究方法,选取2016年2月至2019年4月苏州大学附属第二医院收治的50例脑外伤患者,均在入院后进行MRI以及CT影像学检查,比较两种影像学检查技术的DAI的病灶检出数量,同时对不同类型、是否出血以及不同位置病灶检出率进行比较分析。结果MRI确定的病灶总数为156个,平均(3.12±2.43)个;CT确定的病灶总数为103个,平均(2.06±1.47)个;MRI检查病灶均数明显多于CT,差异具有统计学意义(P<0.05)。MRI检查方式下弥散性脑肿胀以及蛛网膜下腔出血的检出率(66.0%、48.0%)明显高于CT(34.0%、20.0%),差异具有统计学意义(P<0.05);MRI检查方式下非出血病灶的检出率(66.0%)明显高于CT(30.0%)(P<0.05);MRI检查方式下皮质下脑白质、基底节、胼胝体的病灶检出率(64.0%、40.0%、56.0%)明显高于CT(36.0%、18.0%、28.0%),差异具有统计学意义(P<0.05)。结论在弥漫性颅脑轴索损伤临床诊断中,MRI相比CT具有明显的优势,在弥散性脑肿胀、蛛网膜下腔出血等类型以及皮质下、基底节以及胼胝体等位置的病灶检查中敏感性更高,所以在临床诊断中需要根据患者实际情况确定是否需要MRI检查,确保临床诊断的准确性。

Evaluation of the value of CT and MRI in the diagnosis of diffuse craniocerebral injury

Objective To investigate the role of computed tomography(CT)and magnetic resonance imaging(MRI)in the clinical diagnosis of diffuse axonal injury(DAI).Methods A retrospective study was conducted to select 50 patients with traumatic brain injury admitted to the Second Affiliated Hospital of Suzhou University from February 2016 to April 2019.All patients underwent MRI and CT imaging examinations after admission,comparing the two imaging techniques.The number of lesions detected by DAI,and the comparative analysis of different types,bleeding,and detection rate of lesions at different locations.Results The total number of lesions determined by MRI was 156,with an average of(3.12±2.43).The total number of lesions determined by CT was 103,with an average of(2.06±1.47).The mean number of lesions on MRI was significantly higher than that of CT,and the difference was statistically significant(P<0.05).The detection rate of diffuse brain swelling and subarachnoid hemorrhage(66.0%,48.0%)was significantly higher than that of CT(34.0%,20.0%)by MRI.The difference was statistically significant(P<0.05).MRI examination The detection rate of non-hemorrhagic lesions(66.0%)was significantly higher than that of CT(30.0%)(P<0.05).The detection rate of subcortical white matter,basal ganglia and corpus callosum was detected by MRI(64.0%,40.0%,56.0%)was significantly higher than CT(36.0%,18.0%,28.0%),and the difference was statistically significant(P<0.05).Conclusion In clinical diagnosis of diffuse cerebral axonal injury,MRI than CT examination has obvious advantage in diffuse brain swelling,subarachnoid hemorrhage,types and subcortical,corpus callosum and basal ganglia lesion location tests,the sensitivity is higher,so in the clinical diagnosis,it should be determined whether patients need or not performing MRI according to the actual situation to ensure the accuracy of clinical diagnosis.