GRE-T2＊WI联合DWI在急性弥漫性轴索损伤中的诊断价值

目的：探讨磁共振梯度回波T2成像（ GRE-T2＊WI）联合扩散加权成像（ DWI）在急性弥漫性轴索损伤（ DAI）中的诊断价值。方法：回顾性分析38例急性弥漫性轴索损伤（ DAI）患者的头颅MRI检查，比较MRI各序列间的检测灵敏度，并将检出的病灶数与患者入院格拉斯哥昏迷评分（ GCS）行相关性分析。结果：T1WI共检出DAI病灶49个，T2WI检出78个、FLAIR检出139个，GRE-T2＊WI检出142个，DWI检出212个，GRE-T2＊WI联合DWI检出245个。 DWI对非出血性DAI病灶的检出率最高，与其它序列的差异有统计学意义（p＜0．05）。 GRE-T2＊WI对出血性DAI病灶的检出率最高，与其它序列检出率相比有统计学差异（ p＜0．05）。联合GRE-T2＊WI及DWI两种技术对DAI病灶的检出率均显著高于单独应用DWI （p＜0．05）或GRE-T2＊WI （p＜0．05）。联合GRE-T2＊WI及DWI两种技术检出的病灶数目与患者入院GCS呈高度负相关（r＝-0．796， P＜0．01）。结论：GRE-T2＊WI和DWI序列联合应用大大提高DAI病灶的检出率，为临床早期诊断提供更加可靠地影像学依据，应作为MRI检查DAI的常规序列。

THE VALUE OF GRE-T28 WI COMBINED WITH DWI IN THE ACUTE DIAGNOSIS OF DIFFUSE AXONAL INJURY

Objective：To investigate the value of T2＊weighted gradient -recalled-echo（GRE-T2＊WI） and diffusion weighted imaging（DWI） in diagnosis of acute diffuse axonal injury （DAI）.Methods：38 acute DAI patients underwent MRI sequence examina- 〈br〉 tion.The sensitivity of DWI , GRE-T2＊WI and conventional MRI sequence in diagnosis of DAI was compared .The correlation be-tween the number of lesions and initial Glasgow coma score （GCS） was analyzed.Results：The number of lesions detected by T1WI, T2WI, FLAIR, GRE-T2＊WI, DWI and combination GRE-T2＊WI with DWI was 49, 78,139,142,212, and 241 respectively.The detected number of non -hemorrhagic lesion on DWI was the highest and significantly higher than that on other sequences （p〈0.05）. The detected number of hemorrhagic lesion on GRE -T2＊WI was the highest and significantly higher than that on other sequence （ P〈0.05）.The number of lesions detected by combination GRE -T2＊WI with DWI was statistically more than that by DWI or GRE -T2＊WI （p〈0.05）.The number of lesions revealed by combination GRE -T2＊WI with DWI was negatively correlated with GCS （r=-0.796, P〈0.01）.Conclusion：Combination GRE-T2＊WI with DWI can improve detection ratio of DAI lesions by providing more image evidence for early clinical diagnosis , so GRE-T2＊WI and DWI should be the routine sequence in the MRI examination of DAI detection.