弥散加权成像在弥漫性轴索损伤伤情判断和预后评价中的应用价值

目的 探讨弥散加权成像(DWI)对弥漫性轴索损伤(DAI)患者伤情判断和预后评估的价值. 方法 回顾性分析29例DAI患者临床影像学资料及伤后6个月随访结果,比较DWI与常规MRI序列脑内病灶的检出数,分析DWI中不同部位病灶数与患者相应GCS、GOS评分的关系. 结果 (1)29例各序列脑内DAI病灶平均检出数为:DWI(19.24±5.72)个,FLAIR(14.41±4.50)个,T2WI(10.58±3.79)个,T1WI(4.83±2.11)个.DWI的病灶检出数最高,与其他序列比较差异有统计学意义(P<0.05).(2)脑中轴(胼胝体、基底节区、脑干)病灶数与GCS、GOS评分旱负相关(P<0.05),总病灶数及外周病灶数与GCS、GOS评分均无相关性(P>0.05).结论 DWI为DAI病灶检出的敏感序列,脑巾轴病灶检出数可作为DAI患者伤情判断和预后评估的客观指标.

Application of diffusion weighted imaging in severity assessment and prognosis prediction of diffuse axonal injury

Objective To discuss the value of diffusion weighted imaging (DWI) in severity assessment and prognosis prediction of diffuse axonal injury (DAI). Methods A retrospective study was performed on the clinical imaging data and the follow-up results at six months after injury in 29 patients with DAI. The detection rate of DAI lesion by DWI and conventional MRI was compared by means of one-way ANOVA. The correlation between the number of lesion in different areas with GCS and GOS was analyzed with Spearman rank correlation test. Results (1)The average detected DAI lesions were 19.24±5.72 on DWI, 14.41 ±4.50 on FLAIR, 10.58±3.79 on T2WI and 4.83 ±2. 11 on TIWI, with the highest detection number of DAI lesion on DWI (P < 0, 05). (2) There was a significant correlation of the number of central lesions (in corpus callosum, basal ganglia and brain stem) with GCS and COS (P < 0. 05), but there was no correlation of total lesion number or periphery lesion with GCS and COS (P > 0.05). Conclusions DWI is a potentially useful imaging modality in detecting DAI lesion, when the number of central lesion on DWI can be served as an objective marker in severity assessment and prognosis prediction of DAI.