3.0T MRI磁敏感加权成像对轻型脑损伤的评估

目的：探讨3．0T磁敏感加权成像（SwI）对轻型脑损伤的评估价值。方法：搜集54例轻型脑损伤（MTBI）患者的常规MRI、SWI及临床资料，分析比较常规MRI与SWI对MTBI出血灶检出能力的差异。结果：33例有昏迷史（昏迷组），其中脑损伤后综合征（PTBS）20例，非昏迷患者21例（非昏迷组），其中PTBS10例。SWI对昏迷组出血灶检出率明显高于非昏迷组（分别为87．9％和57．1％，P=0．010）；出血灶阳性组PTBS发生率明显高于出血灶阴性组（分别为63．4％和30．8％，P=0．039）。TSE序列及FLAIR序列分别检出19例（35．2％）和28例（51．9％）有出血灶，出血灶数目分别为28个和41个；SwI检出41例（75．9％）有出血灶，出血灶共134个。SwI检出出血灶患者人数明显高于FLAIR和TSE（P〈0．001），SWI检出的出血灶数目亦明显多于FLAIR和TSE序列（P值均〈0．001）。结论：SwI较常规MRI对MTBI患者出血灶有更高的检出能力，实质出血灶的存在影响MTBI患者的远期预后，SWI对此能进行有效评估。

Evaluation of mild traumatic brain injury using susceptibility weighted imaging with a 3.0T MR scanner

Objectives：To investigate the value of susceptibility weighted imaging （SWI） using a 3.0T MR scanner in evaluating mild traumatic brain injury （MTBI）. Methods： The conventional MRI （eMRI）, SWI and clinical materials of 54 patients with MTBI were collected, the differences of feasibility in detecting focal hemorrhage were analyzed and compared. Results：There were 33 patients presented as coma （coma group）, while 21 patients had none conscious disturbance （non-co- ma group）. Of which,20 patients of the coma group and 10 patients of the non-coma group had post-traumatic brain syn- drome （PTBS）. Based on SWI, patients with conscious disturbance （coma group） showed higher incidence of focal hemor- rhage than that of the non-coma group （87.90/00 vs 57.1 %,P=0. 010） ,whereas patients with hemorrhagic focus demonstra- ted higher incidence of PTBS than those with no hemorrhage （63. 4% vs 30. 8%, P 〈3. 039）. On TSE and FI.AIR se- quence,focal hemorrhage was detected in 19 patients （35.2%） and 28 patients （51.9%） respectively,with the number of hemorrhagic foel as 28 and 41 respectively. 41 （75.9%） patients showed hemorrhagic loci on SWI,with the total number of hemorrhagic loci as 134. SWI showed higher sensitivity than FLAIR and TSE （75.9%,51.9%,35.2% respectively）,（P〈 0. 001）. The number of hemorrhagic loci detected by SWI were also more than that detected by FI.AIR and TSE （P〈0. 001）. Conclusions：SWI shows higher sensitivity than cMRI in detecting focal hemorrhage of MTBI patients. The focal hemorrhage within cerebral parenehyma may impact the long-term outcome of MTBI patients,while SWI provides valuable and objective information in this aspect.