3.0TMR-SWI诊断CT阴性急性弥漫性轴索损伤的价值

目的探讨磁敏感加权成像(susceptibility weighted imaging,SWI)在CT阴性的弥漫性轴索损伤(diffuse axonal injury,DAI)的优势。材料与方法 23例脑外伤CT阴性而临床高度怀疑DAI患者3 d内行3.0 T MR检查,检查序列包括T1WI、T2Wl、液体衰减翻转恢复序列(FIAIR)和SWI,分析比较各序列上脑内轴索损伤病灶检出率和病灶数目的差异性,分析SWI技术指标与格拉斯哥昏迷评分(glasgow coma scale,GCS)的相关性。结果 DAI病灶主要分布于脑灰白质交界区和白质深部。常规Tl WI、T2WI、FLAIR和SWI序列对DAI病灶检出率分别为23.8%、32.2%、46.5%和83.8%,而微小出血灶检出数目分别为31、68、103、326;SWI与T1WI、T2WI和FLAIR在病灶检出率和病灶数目的差异有显著的统计学意义(P0.01)。SWI显示的出血性病灶与患者入院时GCS评分呈高度负相关(r=-0.876)。结论与传统序列比较,SWI对DAI出血性病灶的检出具有极高的敏感性,且能很好地反映病情,为DAI早期临床诊断及预后评价提供更多客观依据。

The value of 3.0 T MR-SWI in diagnosis of diffuse axonal injury with non-lesional CT ifndings

Objective:To investigate the advantages of 3.0 T MR susceptibility weighted imaging (SWI) in diagnosis of diffuse axonal injury (DAI) with non-lesional CT findings.Materials and Methods:Twenty-three patients sufferred from brain trauma with non lesional CT ifndings were highly suspected DAI, and these patients were underwent 3.0 T MR exmination in 3 days after brain trauma, included T1WI, T2WI, FLAIR and SWI sequences. The sensitivity and lesional numbers of theses sequences in detecting lesions were compared, in additon, the relation of lesion numbers in SWI with GCS scores were studied.Results:The lesions concentrated in brain gray matter border zone and deep white matter. Detection rates of TlWI, T2WI, FLAIR and SWI were 23.8%, 32.2%, 46.5% and 83.8%, respectively. Additionally, the number of lesions detected was 31, 68, 103 and 326 respectively on TlWI, T2WI, FLAIR and SWI sequences. The number of lesions detected by SWI was statistical more than conventional sequence (P<0.01).The number of lesions in SWI was negatively correlated markedly with GCS (r=-0.876).Conclusion:SWI can be more completely to display hemorrhagic lesions associated with DAI and be better estimated the condition of patients.