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磁共振磁敏感成像在弥漫性轴索损伤中的临床应用研究
引用本文:陈新坚,程传虎,肖俊强,黄旭东,李王安,钟兰生,汪欣,赖海辉. 磁共振磁敏感成像在弥漫性轴索损伤中的临床应用研究[J]. 中国CT和MRI杂志, 2016, 0(8). DOI: 10.3969/j.issn.1672-5131.2016.08.032
作者姓名:陈新坚  程传虎  肖俊强  黄旭东  李王安  钟兰生  汪欣  赖海辉
作者单位:1. 广东省惠州市第一人民医院放射科 广东 惠州 516003;2. 广东省惠州市第一人民医院神经 外科 广东 惠州 516003
基金项目:2013年惠州市科技计划项目(医疗卫生第一批)立项项目(2013Y058)
摘    要:目的研究磁共振敏感成像(SWI)在弥漫性轴索损伤(DAI)诊断及预后评估中的应用价值。方法收集我院2012年7月-2015年12月收治的50例DAI患者,均作MRI常规平扫及SWI扫描,入院后所有患者均作格拉斯哥昏迷评分(GCS),分析SWI对DAI诊断价值,评估其与GCS评分的相关性。结果 DAI出血性病灶MR常规序列呈低信号或等信号,SWI低信号;病变附近有环样水肿带,T1WI低信号,T2WI、FLAIR序列、T2-FFE序列高信号,病灶形态不规则、大小不等。SWI序列共检出DAI病灶681个,高于MR常规各序列;SWI检出病灶总体积明显大于T2-FFE,对比差异有统计学意义(P0.05);SWI序列检出病灶数目及病灶总体积均与GCS评分呈负相关(r=-0.823、-0.766,P0.05)。结论 SWI序列可检出更多DAI病灶,其所见DAI病灶数目、体积与GCS评分呈负相关,与预后密切关联。

关 键 词:弥漫性轴索损伤  磁共振  磁敏感加权成像  预后

Clinical Application of Susceptibility Weighted Imaging in Diffuse Axonal Injury
Abstract:Objective To study the application value of susceptibility weighted imaging (SWI) in the diagnosis and prognostic evaluation of diffuse axonal injury (DAI).Methods 50 cases of DAI patients who admitted into our hospital between July 2012 and June 2015 were collected. All underwent routine MRI scan and SWI scan. Glasgow coma score (GCS) was performed in all patients after admission. The value of SWI in the diagnosis of DAI was analyzed and its correlation with GCS score was evaluated.Results MR routine sequence of DAI hemorrhagic lesions showed low signal or equal signal on T1WI and low signal on SWI. There was ring-like edema zone around lesions, low signal on T1WI, high signal on T2WI, FLAIR and T2-FFE. The shapes of lesions were uneven. SWI sequences detected a total of 681 DAI lesions, higher than those detected by MR routine sequences. The total volume of lesions detected by SWI was significantly larger than T2-FFE (P<0.05). The number of lesions and the total volume of lesions detected by SWI were negatively correlated with GCS score (r=-0.823, -0.766, P<0.05).Conclusion SWI sequences detected more DAI lesions. The number and volume of DAI lesions were negatively correlated with GCS score and correlated with the prognosis.
Keywords:Diffuse Axonal Injury  Magnetic Resonance Imaging  Magnetic Susceptibility Weighted Imaging  Prognosis
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