CAJ | 학술논문

目的：探讨磁共振梯度回波T2成像（T2*GRE）联合扩散加权成像（DWI）在弥漫性轴索损伤（diffuse axonal injury，DAI）中的诊断价值。方法回顾性分析33例急性弥漫性轴索损伤（DAI）患者的头颅MRI检查，比较各序列的敏感度，并将检出的病灶数与患者入院格拉斯哥昏迷评分（GCS）行相关性分析。结果 T1 WI共检出DAI病灶97个，T2 WI检出159个、FLAIR检出253个，DWI检出301个，T2*GRE检出441个，T2*GRE联合DWI检出502个。DWI对非出血性DAI病灶的检出率最高，与序列相比差异有统计学意义（P＜0.05）。T2*GRE对出血性DAI病灶的检出率最高，与序列相比差异有统计学意义（P＜0.05）。联合T2*GRE及DWI两种技术对DAI病灶的检出率均显著高于单独应用DWI（P＜0.05）或T2*GRE（P＜0.05）。联合T2*GRE及DWI两种技术检出的病灶数目与患者入院GCS呈高度负相关（r＝-0.749，P＜0.01）。结论 T2*GRE和DWI序列联合应用显著提高DAI病灶的检出率，应作为MRI检查DAI的常规序列。
목적：탐토자공진제도회파T2성상（T2*GRE）연합확산가권성상（DWI）재미만성축색손상（diffuse axonal injury，DAI）중적진단개치。방법회고성분석33례급성미만성축색손상（DAI）환자적두로MRI검사，비교각서렬적민감도，병장검출적병조수여환자입원격랍사가혼미평분（GCS）행상관성분석。결과 T1 WI공검출DAI병조97개，T2 WI검출159개、FLAIR검출253개，DWI검출301개，T2*GRE검출441개，T2*GRE연합DWI검출502개。DWI대비출혈성DAI병조적검출솔최고，여서렬상비차이유통계학의의（P＜0.05）。T2*GRE대출혈성DAI병조적검출솔최고，여서렬상비차이유통계학의의（P＜0.05）。연합T2*GRE급DWI량충기술대DAI병조적검출솔균현저고우단독응용DWI（P＜0.05）혹T2*GRE（P＜0.05）。연합T2*GRE급DWI량충기술검출적병조수목여환자입원GCS정고도부상관（r＝-0.749，P＜0.01）。결론 T2*GRE화DWI서렬연합응용현저제고DAI병조적검출솔，응작위MRI검사DAI적상규서렬。
Objective To investigate the value of T2*-weighted gradient-recalled-echo(GRE)MRI and diffusion-weighted imaging(DWI)in the diagnosis of acute diffuse axonal injury(DAI).Methods 33 patients with acute DAI underwent conventional MRI including T1-,T2-,and FLAIR-weighted images as well as T2*-weighted GRE MRI and DWI.The sensitivities of the pulse sequences for diagnosing DAI were compared.The number of lesions was correlated with the initial Glasgow coma score(GCS).Results The number of detected non-hemorrhagic lesions was significantly (P<0.05)higher on DWI than that on other sequences whereas the detected number of hemorrhagic lesions was significantly higher on T2*-weighted GRE(P<0.05).Significantly more lesions were detected on combined T2*-weighted GRE MRI and DWI than either sequence alone(P<0.05).The number of lesions detected on combined imaging was negatively correlated with GCS(r=-0.749,P<0.01).Conclusion Combined T2*-weighted GRE MRI and DWI can improve detection of DAI lesions for early diagnosis.