磁敏感加权成像在弥漫性轴索损伤中的应用价值

目的通过比较磁敏感加权成像(susceptibility weighted imaging,SWI)与常规MRI序列对弥漫性轴索损伤(diffuse axonal injury,DAI)病灶的显示情况,探讨SWI对DAI的诊断价值;比较SWI及常规MRI序列在检测DAI病灶数目及体积方面的差别,探讨SWI显示DAI病灶数目、体积与患者格拉斯哥昏迷评分(glasgow coma score,GCS)之间的相关性。资料与方法对36例临床确诊为DAI的患者分别行常规MRI及SWI扫描;常规MRI与SWI在显示病灶数目及体积方面分别采用U检验及配对t检验。结果 SWI显示DAI病灶分布于皮髓质交界以及白质区域,呈"斑点"状、"串珠"状、"线条"状明显低信号病灶;常规MRI序列检出96个病灶,SWI检出511个病灶,两种方法在检测病灶数目方面差异具有统计学意义(Z=-6.801,P=0.000)。常规序列检测病灶总体积约29.09 cm3,SWI显示病灶总体积约为66.95 cm3,两种方法在检测病灶总体积方面差异具有统计学意义(t=-7.916,P=0.000)。SWI显示病灶数目与患者GCS之间存在负相关性(r=-0.796,P=0.000);SWI显示病灶体积与患者GCS之间存在负相关性(r=-0.652,P=0.000)。结论 SWI在显示DAI病灶及评价患者病情方面优于常规MRI序列。

The Utilization Value of Susceptibility Weighted Imaging in Diffuse Axonal Injury

Objective By comparing the sequences of SWI and conventional MR in the DAI lesions,to explore the diagnostic value of SWI sequence in diffuse axonal injury.To verify differences between SWI sequence and conventional MR sequence in the number and volume of DAI lesions.Materials and Methods Thirty-six DAI patients underwent conventional MRI and SWI sequence scan.Application u nonparametric test to compare the number of DAI lesions between conventional and SWI sequences.The differences of volume of DAI lesions between conventional and SWI sequences used paired Samples t test.Results The DAI lesions showed by the SWI sequence were located in the corticomedullary junction,white matter,basal ganglia,corpus callosum,brain stem,and cerebellar,and they were showed spotty,patchy,beaded significant lower signal on the SWI sequence.96 lesions had been found by conventional MR sequence scan,while 511 lesions had been found by SWI sequence.There were statistical differences in the number of lesions by the two method(Z=-6.801,P=0.000).The total volume of DAI lesions in conventional MRI and SWI were about 29.09 cm3,66.95 cm3,respectively.There were statistical differences in the volume of DAI lesions(t=-7.916,P=0.000).The number of DAI lesions had a negative relation with GCS(r=-0.796,P=0.000).The volume of DAI lesions had a negative relation with GCS(r=-0.652,P=0.000).Conclusion The SWI sequence is superior to conventional MR sequence in detect DAI lesions.