中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
7期
632-636
,共5页
韩成坤%史浩%刘桂芳%蔡小涛%郭红霞%张永霞%宋丹%张文浩
韓成坤%史浩%劉桂芳%蔡小濤%郭紅霞%張永霞%宋丹%張文浩
한성곤%사호%류계방%채소도%곽홍하%장영하%송단%장문호
弥漫性轴索损伤%磁共振成像%脑损伤
瀰漫性軸索損傷%磁共振成像%腦損傷
미만성축색손상%자공진성상%뇌손상
Diffuse axonal injury%Magnetic resonance imaging%Brain injuries[1]Haacke EM,Xu Y,Cheng YCN,et al. Susceptibility weighted imaging (SWI). Magn Reson Med,2004,52:612-618. [2]Le Bihan D,Mangin JF,Poupon C,et al. Difusion tensor imaging: concepts an
目的 探讨磁敏感加权成像(SWI)对弥漫性轴索损伤(DAI)的诊断价值及与临床、预后的关系.方法 对20例临床确诊为DAI的脑外伤患者行3.0 T MR常规序列扫描[包括T1WI、T2WI、液体衰减反转恢复(FLAIR)序列]及SWI序列扫描,格拉斯哥评分(GCS)为3.0~5.0分者8例,6.0~8.0分者4例,9.0~12.0分者8例.分别为伤后3 h至20 d内行MR扫描并加扫SWI序列,分别测量所有患者在MR常规序列扫描和SWI的病灶数量及体积.常规扫描序列和SWI检出病灶数量的比较采用Mann-Whitney U检验,病灶体积比较采用配对t检验,观察有无差异;SWI检查与临床、预后采用Pearson相关分析.结果 DAI病灶在SWI表现为:脑内皮髓质交界区、脑白质、基底节、胼胝体、脑干、小脑等区域散在大小不等的点状、串珠状、斑片状、条索状显著低信号灶(病灶直径<2.0 cm),病灶分布呈多灶性,大小不均,边界清晰.MRI常规序列扫描共发现78个病灶;SWI序列共发现424个病灶,SWI序列发现病灶数量明显多于常规MR扫描(U=-15.447,P<0.01);分别测量MRI常规序列扫描和SWI序列发现的病灶体积为19 340 mm3和38 042 mm3,两者比较差异有统计学意义(t=5.870,P<0.01).其中SWI序列显示的病灶数量和病灶体积与GCS评分之间呈明显的负相关,相关系数分别为-0.802、-0.767,P值均<0.01.结论 SWI序列可以在DAI患者中发现更多的出血病灶及较常规扫描明显扩大的病灶体积,并且病灶的体积和数量与GCS评分密切相关,对DAI的诊断及判断患者的预后有很高的价值.
目的 探討磁敏感加權成像(SWI)對瀰漫性軸索損傷(DAI)的診斷價值及與臨床、預後的關繫.方法 對20例臨床確診為DAI的腦外傷患者行3.0 T MR常規序列掃描[包括T1WI、T2WI、液體衰減反轉恢複(FLAIR)序列]及SWI序列掃描,格拉斯哥評分(GCS)為3.0~5.0分者8例,6.0~8.0分者4例,9.0~12.0分者8例.分彆為傷後3 h至20 d內行MR掃描併加掃SWI序列,分彆測量所有患者在MR常規序列掃描和SWI的病竈數量及體積.常規掃描序列和SWI檢齣病竈數量的比較採用Mann-Whitney U檢驗,病竈體積比較採用配對t檢驗,觀察有無差異;SWI檢查與臨床、預後採用Pearson相關分析.結果 DAI病竈在SWI錶現為:腦內皮髓質交界區、腦白質、基底節、胼胝體、腦榦、小腦等區域散在大小不等的點狀、串珠狀、斑片狀、條索狀顯著低信號竈(病竈直徑<2.0 cm),病竈分佈呈多竈性,大小不均,邊界清晰.MRI常規序列掃描共髮現78箇病竈;SWI序列共髮現424箇病竈,SWI序列髮現病竈數量明顯多于常規MR掃描(U=-15.447,P<0.01);分彆測量MRI常規序列掃描和SWI序列髮現的病竈體積為19 340 mm3和38 042 mm3,兩者比較差異有統計學意義(t=5.870,P<0.01).其中SWI序列顯示的病竈數量和病竈體積與GCS評分之間呈明顯的負相關,相關繫數分彆為-0.802、-0.767,P值均<0.01.結論 SWI序列可以在DAI患者中髮現更多的齣血病竈及較常規掃描明顯擴大的病竈體積,併且病竈的體積和數量與GCS評分密切相關,對DAI的診斷及判斷患者的預後有很高的價值.
목적 탐토자민감가권성상(SWI)대미만성축색손상(DAI)적진단개치급여림상、예후적관계.방법 대20례림상학진위DAI적뇌외상환자행3.0 T MR상규서렬소묘[포괄T1WI、T2WI、액체쇠감반전회복(FLAIR)서렬]급SWI서렬소묘,격랍사가평분(GCS)위3.0~5.0분자8례,6.0~8.0분자4례,9.0~12.0분자8례.분별위상후3 h지20 d내행MR소묘병가소SWI서렬,분별측량소유환자재MR상규서렬소묘화SWI적병조수량급체적.상규소묘서렬화SWI검출병조수량적비교채용Mann-Whitney U검험,병조체적비교채용배대t검험,관찰유무차이;SWI검사여림상、예후채용Pearson상관분석.결과 DAI병조재SWI표현위:뇌내피수질교계구、뇌백질、기저절、변지체、뇌간、소뇌등구역산재대소불등적점상、천주상、반편상、조색상현저저신호조(병조직경<2.0 cm),병조분포정다조성,대소불균,변계청석.MRI상규서렬소묘공발현78개병조;SWI서렬공발현424개병조,SWI서렬발현병조수량명현다우상규MR소묘(U=-15.447,P<0.01);분별측량MRI상규서렬소묘화SWI서렬발현적병조체적위19 340 mm3화38 042 mm3,량자비교차이유통계학의의(t=5.870,P<0.01).기중SWI서렬현시적병조수량화병조체적여GCS평분지간정명현적부상관,상관계수분별위-0.802、-0.767,P치균<0.01.결론 SWI서렬가이재DAI환자중발현경다적출혈병조급교상규소묘명현확대적병조체적,병차병조적체적화수량여GCS평분밀절상관,대DAI적진단급판단환자적예후유흔고적개치.
Objective To study the diagnostic value of susceptibility weighted imaging (SWI) in diffuse axonal injury (DAI) and investigate the relationship between SWI and clinical prognosis. MethodsTwenty patients (15 males and 5 females) with DAI were included in this study. Routine sequences (T1WI, T2WI and FLAIR) and SWI were performed on a 3.0 T MRI scanner. There were 8 cases whose Glasgow score scale (GCS) ranged from 3.0 to 5.0, 4 cases from 6.0 to 8.0 and 8 from 9.0 to 12.0. The interval time between injury and examination were from 3 hours to 20 days. The number and volume of lesions observed on SWI and routine sequence were compared using Mann-Whitney U-test and paired t-test. Pearson correlation was used to analyze the relationship between the number and volume of all lesions and GCS. Results The lesions showed punctate, beaded, patchy and cord-like hypointense signal with various size on SWI (lesion diameter <2.0 cm). Distribution of lesions was multifocal with clear boundary. Routine MRI scan found a total of 78 lesions, while SWI sequence detected 424 lesions. The number of the lesions found on SWI was more than that on conventional MRI (U=-15.447,P<0.01). The total volume of the lesions measured on routine MRI and SWI were 19 340 mm3 and 38 042 mm3, respectively. The total volume measured on SWI was more than that on routine MR (t=5.870,P<0.01). The number and volume of all lesions were negatively correlated with GCS (r=-0.802, -0.767, P<0.01). Conclusion SWI sequence could find more bleeding lesions than the routine MRI sequences. The number and the volume of the lesions were closely related to GCS. SWI showed high value in the diagnosis and prediction of the prognosis of DAI.