磁共振扩散张量成像对轻型颅脑损伤患者评价的临床应用

目的通过核磁共振扩散张量成像(diffusion tensor imaging,DTI)评估轻型颅脑损伤患者颅内损伤情况,探讨DTI在轻型颅脑损伤患者诊断中的应用价值。材料与方法收集CT检查未见出血及骨折的轻型颅脑损伤患者30人,正常对照组30人。在受伤后7天内,行头部MRI检查,并在行头MRI检查当天用Rivermead脑震荡后综合征评估表进行评分。结果轻型颅脑损伤组Rivermead脑震荡后综合征评分高于对照组。轻型颅脑损伤组FA值升高区域有:右侧小脑半球、右侧枕叶及小脑山坡,舌回,右侧额下回的三角部,楔前叶灰质。轻型颅脑损伤组FA值降低区域有:视辐射,大脑脚,右侧胼胝体膝,左侧胼胝体膝,右侧额中回下白质,中央前回下白质。结论轻型颅脑损伤患者存在器质性颅内改变。扩散张量成像对于轻型颅脑损伤造成的颅内病变非常敏感,可以为临床诊断轻型颅脑损伤提供参考依据,并为判断轻型颅脑损伤预后提供一定帮助。

Clinical application of DTI in mild traumatic brain injury and its signiifcance

Objective: The purpose of this study was to detect intracranial axonal damage after mild traumatic brain injury using diffusion tensor imaging (DTI), and assess the application of DTI in mild traumatic brain injury clinically. Materials and Methods:Thirty patients were prospectively enrolled from Tianjin First Center Hospital, who sustained a mild TBI, 30 normal volunteers were also recruited as control. All the participants underwent routine MRI, DTI scanning, and Rivermead Post Concussion Symptoms Questionnaire (RPQ) within the day of examination. Results:The RPQ scores of mTBI patients were higher than control (P<0.01). Whole brain analysis of DTI revealed the areas with higher FA values: right cerebellum, occipital lobe, declive, lingual gyrus, the triangular part of right inferior frontal gyrus, Precuneus. The areas with lower FA values were the optic radiation, cerebral peduncle, corpus callosum, the white matter under middle frontal gyrus, the white matter under precentral gyrus. Conclusion:We had shown that DTI can identify abnormalities in patients following mTBI. DTI were sensitive in finding intracranial latent lesion by mTBI. We believed such early identiifcation could certainly be used to help diagnosis, and might play a key role in prognosis of mTBI.