外伤性胼胝体损伤的MRI诊断

目的] 观察颅脑创伤致胼胝体损伤的MRI表现,为临床提供有价值的诊断信息,提高颅脑创伤的救治水平. 方法 回顾分析临沂市人民医院神经外科自2007年至2009年收治疗的20例MRI证实为胼胝体损伤患者的临床、影像资料,观察其临床表现及MRI各序列特征. 结果 外伤性胼胝体损伤在临床较为少见,以非出血性损伤为主,损伤部位常见于体部及压部,少数位于膝部,嘴部损伤罕见.对于早期非出血性损伤,MRI常表现为稍长T1稍长T2信号,且常伴弥漫性轴索损伤的表现.在胼胝体损伤的中后期,胼胝体局部往往萎缩,病灶区易出现液化坏死,可有胶质瘢痕及软化灶形成,在MR/表现为长T1长T2信号,且信号强度近似于脑脊液,还可见相应部位的脑室扩大.在弥散加权成像(DWI)可见非出血性损伤在急性期和亚急性期呈高信号,随着时间延长,信号逐渐减低至正常脑组织信号,如形成软化灶,则表现为脑脊液信号. 结论 外伤性胼胝体损伤可引起严重后果,在重型颅脑损伤中并不罕见,应当引起临床医生重视.MRI是显示胼胝体损伤病灶最好的影像学检查手段,不仅对其微小病变敏感显示,且能够多方位地显示病变.

MRI diagnosis of traumatic injury to corpus cllosum

Objective To observe the MRI features of traumatic brainin jury to corpus callosum and provide valuable diagnostic information for clinical application. Methods Clinical and radiological data were retrospectively analyzed in 20 MRI-diagnosed patients as having traunmtic brain mjury to corpus callosum. Results Traumatic injury to corpus callosum was rather rare in brain trauma.Most traumatic injury to corpus callosum was non-hemorrhagic and its lesion mainly laid at its body or splenium,sometimes at genu,but rarely at rostrum.Traumatic injury to corpus callosum,being one of the common manifestations in diffuse axonal injury(DAI), could be demonstrated slight hyperintense signal on TI WI and T2WI in early phase.The injury site shrank and liquefaction necrosis appeared in the lesion at the late-mid-injured period with softened focus or gliai scar.MRI showed hyperintense T1 and T2 signal, similar to the signal of the cerebrospinal fluid and demonstrated ventriculomegaly in the corresponding parts.DWI showed hyperintense signal in the lesion in acute and subacutc stages:with time prolonged,isointense signal of the normal brain tissue was found and signal of the cerebrospinal fluid appeared in the present of softened focus.Conclusion Attention should be paid to the traumatic injury to corpus callosum,an indicator for severe trauma or disease.MRI,a sensitive and multi-directional imaging,is superior in detecting non-hemorrhagic injury to the corpus callosum.