弥漫性轴索损伤的CT影像分析

目的探讨CT对弥漫性轴索损伤（DAI）的诊断价值。方法回顾性分析临床确诊的56例DAI患者的CT特点及临床表现。结果CT表现：①脑灰白质交界区、胼胝体及其周围、脑干、基底节区多发或单发小出血灶；②弥漫性白质密度减低，灰白质界线不清，双侧脑室和脑池受压、变窄或消失；③合并硬膜下血肿、脑室及蛛网膜下腔出血、骨折等。临床表达为深昏迷，GCS评分≤6～7分，生命指征紊乱，瞳孔散大，光反射消失。结论CT影像结合临床表现对DAI有较高的诊断价值。

CT Diagnosis of Diffuse Axonal Injury

Objective To investigate the diagnostic value of CT for the diffuse axonal injury （DAI）. Method The clinical and image data of 56 patients with DAI treated in our hospital in the last 5 years were analysed retrospectively. Results CT scanning showed that there were single or more small hemorrhage foci in the cerebral gray-white matter junction, brain stem, basal ganglia, and corpus callosum and area around it. The diffuse decrease in white matter density, obscure boundary between the gray and white matters, and compression and narrowing or disappearance of both the lateral ventricles and cerebral cisterns were observed on CT images. In general, DAI was accompanied with subarachnoid hemorrhage, subdural hematoma and fracture of cranial bone. The clinical manifestations of DAI included deep coma, GCS ≤6-7, disordered life sign, mydriasis and disappearance of light reflection. Conclusion CT scanning combined with the clinical manifestations was of very important value to the diagnosis of DAI.