应用MRI分级预测颅脑损伤长期意识障碍患者的清醒时间及预后

目的 探讨颅脑损伤长期意识障碍患者MRI分级与清醒时间及预后的关系.方法 收集珠江医院神经外科自2003年至2008年收治的66例重型颅脑损伤后意识障碍超过2周的患者,记录患者颅脑MRI表现并进行分级;记录所有清醒患者损伤后清醒时间;预后以患者伤后6个月时GOS评分进行判别.结果 患者预后(GOS评分)与MRI分级存在联系,分级越高者,预后越差;MRI对预后的预测准确率为83.33%.MRI分级为Ⅰ级和Ⅱa级的清醒患者的平均清醒时间为(8.00±4.10)周,MRI分级为Ⅱb级和Ⅲ级的清醒患者的平均清醒时间为(22.67±23.66)周.结论 颅脑损伤长期意识障碍患者的头颅MRI分级与患者的清醒时间及预后有关,应用MRI分级可客观、准确的预测患者的预后.

Using MRI classification to predict the time of awakening and prognosis in patients with longterm consciousness disorders after traumatic brain injury

Objective To investigate the relationship between MRI classification and both time of awakening and prognosis in patients with long-term consciousness disorders after traumatic brain injury. Methods Sixty-six patients, admitted to our hospital from 2003 to 2008 and suffered from severe traumatic brain injury with consciousness disorders for more than 2 weeks, were collected. The cranial MRI data of all patients were recorded and classified; the awakening time of all conscious patients after injury was recorded; the prognoses were judged by Glasgow outcome scale 6 month after the injury.The relationship between MRI classification and both time of awakening and prognosis were analyzed.Results The prognoses (the scores of Glasgow outcome scale) were closely associated with the cranial MRI classification; the higher the MRI classification, the poorer the prognosis; the accuracy rate of MRI in assessing the prognosis was 83.33%. The average awakening times were (8.00±4.10) weeks in patients with graded Ⅰ and Ⅱa of MRI classification, and (22.67±23.66) weeks in patients with graded Ⅱb and Ⅲ of MRI classification. Conclusions The MRI classification is correlative to the prognosis and the awakening time of the patients with long-term consciousness disorders after severe traumatic brain injury.Using MRI classification can objectively and accurately evaluate patients' prognosis.