CAJ | 학술논문

目的探讨重型颅脑损伤长期意识障碍患者磁共振成像(MRI)表现与预后的关系.方法收集珠江医院神经外科自2003年1月至2008年8月收治的66例重型颅脑损伤后意识障碍超过2周的患者的头部MRI资料,统计MRI横断位扫描T2WI像中脑干、丘脑、基底前脑、胼胝体、大脑皮层下及大脑皮层等区域的异常信号表现,以颅脑损伤后6个月患者是否清醒分为清醒组与非清醒组,运用Logistic回归分析计算患者头部MRI中的损伤灶位置与清醒与否的OR值,明确对预后有影响的独立危险因素.结果头颅MRI中脑干腹侧及背侧、双侧基底前脑、双侧丘脑、胼胝体、双侧大脑额叶区域损伤和未损伤患者在清醒组与非清醒组间比较差异有统计学意义(P<0.05).Logistic回归分析显示脑干背侧损伤、丘脑右侧损伤、胼胝体损伤是影响预后的独立危险因素.结论 MRI表现可较客观、准确地反映脑损伤程度和预测患者的预后,脑干中上段背侧、胼胝体、丘脑有损伤灶的患者预示着难以清醒.
목적 탐토중형로뇌손상장기의식장애환자자공진성상(MRI)표현여예후적관계.방법 수집주강의원신경외과자2003년1월지2008년8월수치적66례중형로뇌손상후의식장애초과2주적환자적두부MRI자료,통계MRI횡단위소묘T2WI상중뇌간、구뇌、기저전뇌、변지체、대뇌피층하급대뇌피층등구역적이상신호표현,이로뇌손상후6개월환자시부청성분위청성조여비청성조,운용Logistic회귀분석계산환자두부MRI중적손상조위치여청성여부적OR치,명학대예후유영향적독립위험인소.결과 두로MRI중뇌간복측급배측、쌍측기저전뇌、쌍측구뇌、변지체、쌍측대뇌액협구역손상화미손상환자재청성조여비청성조간비교차이유통계학의의(P<0.05).Logistic회귀분석현시뇌간배측손상、구뇌우측손상、변지체손상시영향예후적독립위험인소.결론 MRI표현가교객관、준학지반영뇌손상정도화예측환자적예후,뇌간중상단배측、변지체、구뇌유손상조적환자예시착난이청성.
Objective To explore the correlation between magnetic resonance imaging(MRI)manifestations and the prognosis in long-term consciousness disorder patients with severe traumatic brain injury(TBI).Methods MRI data were collected in 66 patients with a duration of disturbance of unconsciousness for more than 2 weeks.These patients suffered from severe TBI and were admitted to our hospital from January 2003 to August 2008.The data about regions of abnormal signal in T2WI in the brain stem,the thalamus,the basal forebrain,the corpus callosum,the cerebral cortex and the subcortical area were recorded and analyzed.The patients were divided into conscious and unconscious groups based on the outcome 6 months after the injury.Logistic regression analysis was used to calculate the OR value between the lesions and the poor outcome of the patients.Results The lesions of the dorsal upper brain stein,the thalamus and the corpus callosum between the conscious and unconscious groups were significantly different.The lesions of the dorsal upper brain stem,the corpus callosum and the thalamic by MRI predict the poor outcomes.Conclusion The MRI manifestations can demonstrate the cerebral dysfunction and probabilities of patients' outcome objectively and accurately.