SWI在弥漫性轴索损伤中脑内出血灶的诊断应用

目的利用磁敏感加权成像(SWI)了解弥漫性轴索损伤(DAI)出血灶的表现并探讨SWI在外伤性DAI中出血灶的应用价值。资料与方法20例DAI患者行3.0T磁共振SWI。观察DAI脑内出血灶在SWI上的形态、分布、数目等,并与昏迷程度、昏迷天数以及预后等进行对比或相关分析。结果DAI的出血灶在SWI像上表现为斑点状,线条状,小团状低信号,病灶最大径最大者15mm,最小者<0.5mm。DAI出血灶在脑表浅部分布较后颅窝和脑深部多。DAI出血灶总数分别与格拉斯哥昏迷评分(GCS)和昏迷天数呈负相关(r=-0.931,P=0.000)和正相关(r=0.924,P=0.000)。预后不良组患者DAI出血灶数大于恢复良好组。结论SWI有助于显示DAI出血灶,从而能够较好地解释DAI的临床症状,并对判断DAI患者的预后亦有一定价值。

Application of SWI in Diagnosis of Intracerebral Hemorrhage Caused by Diffuse Axonal Injury

Objective To explore the SWI appearance of intracerebral hemorrhage caused by diffuse axonal injury (DAI) and its diagnostic value. Materials and Methods Total 20 cases of DAI [11 male,9 female, average age ( 34.9 ± 15.9) years old]were examined with SWI on 3.0T M R scanner. The distribution, shape, number of intracerebral hemor-rhage showed in SWI were analyzed. The result were correlated with degree of coma,course of being in coma state and prog-nosis. Results On SWI image the hemorrhage of DAI represented as stippled, line, pellet -like hypointense lesions,the largest dimension of lesion was more than 15 mm,and smallest less than 0.5 mm;The lesion had a predilection of superfi-cial location to deep and posterior cranial fossa location in cerebrum. The positive ( r = 0. 924, P = 0.000 ) and negative( r = -0. 931, P = 0. 000)correlation were found respectively between lesions and course of being in coma state and GCS score. The group with unfavorable prognosis showed more hemorrhage than that in favorable group. Conclusion SWI is helpful for detecting intracerebral hemorrhage caused by DAI, which could explain the clinical symptoms better, SWI has certain values to predict outcome.