脑弥漫性轴索损伤的临床和CT分析

目的探讨脑弥漫性轴索损伤（diffuse axonal injury）的临床及CT表现特点。方法对45例DAI患者的临床及CT资料进行分析。结果车祸伤是致DAI发生的主要原因，临床表现以伤后原发性昏迷，且持续时间较长为特点，预后不良，死亡率及致残率高。DAI的主要CT表现为弥漫性脑肿胀，大脑灰白质交界处、基底节内囊区、胼胝体、脑干单发或多发无占位效应的出血灶，直径小于2cm；可伴有蛛网膜下腔和／或脑室出血、硬膜下出血等。结论CT结合临床能提高DAI的诊断准确性。

Clinical presentation and CT imaging analysis of the diffuse axonal injury

Objective To study the clinical and CT features of the diffuse axonal injury （DAI）. Methods The clinical and CT informations of 45 patients with DAI were analysed retrospectively. Results Traffic accident was the main traumatic cause in patients with DAI. The clinical presentations of DAI were primarily prolonged coma and unfavourable prognosis with high mortality and morbidity rate. The manifestations on CT scan were generalized brain swelling and the presence of one or more hemorrhagic lesions with diameter less than 2era in the corticomedullary junction, basal ganglia, internal capsule, corpus callosum or brain stem. The lesions were accompanying with subdural hematoma （SDH）, subarachnoid hemorrhage （SAH） and/or intraventricular hemorrhage without obvious intracranial hematoma and contusion. Conclusions Synthetically analysing the clinical and CT features of DAI should be done for improving the diagnostic accuracy.