CAJ | 학술논문

目的：探讨磁敏感加权成像（SWI）及液体衰减反转恢复（FLAIR）序列在儿童创伤性颅内出血中的诊断价值。方法：36例颅脑外伤患儿，年龄3天～9岁，平均（2．6±2．6）岁。所有患者采用3．0T MR 机进行 T1 WI、T2 WI、SWI及 FLAIR 序列扫描。对比常规 MRI 序列（T1 WI，T2 WI）与 SWI 和 FLAIR 序列三种检查方法在发现脑实质微出血（CMBs）、硬膜下或外出血、蛛网膜下腔出血（SAH）及脑室内出血的数量有关差异，并分析颅内各种出血的信号特点。结果：36例中常规 MRI、SWI 和 FLAIR 序列检出的脑实质微出血灶分别为80、197和65个，检出的硬膜下或外出血分别为45、45和44个部位，检出的 SAH 分别为7、10和13例，分别检出4、7和4例患儿存在脑室内出血。在检出脑实质微出血中，SWI 与常规 MRI（χ2＝166．419，P ＝0．001）和 FLAIR 序列（χ2＝198．504，P ＝0．001）间差异有统计学意义（P ＜0．05）。在检出 SAH 方面，FLAIR 序列与常规 MRI 序列间差异有统计学意义（P ＝0．015）。颅内出血的信号特点较复杂， SWI 图像上颅内出血，尤其是硬膜下或外出血，可以表现为高信号或混杂信号。结论：SWI 较常规 MRI 和 FLAIR 序列能发现更多的微出血灶及脑室内出血，FLAIR 序列在检出 SAH 方面具有独特的优势，综合应用 MRI 扫描序列对于儿童创伤性颅内出血的诊断及预后的判断有很高的价值。
목적：탐토자민감가권성상（SWI）급액체쇠감반전회복（FLAIR）서렬재인동창상성로내출혈중적진단개치。방법：36례로뇌외상환인，년령3천～9세，평균（2．6±2．6）세。소유환자채용3．0T MR 궤진행 T1 WI、T2 WI、SWI급 FLAIR 서렬소묘。대비상규 MRI 서렬（T1 WI，T2 WI）여 SWI 화 FLAIR 서렬삼충검사방법재발현뇌실질미출혈（CMBs）、경막하혹외출혈、주망막하강출혈（SAH）급뇌실내출혈적수량유관차이，병분석로내각충출혈적신호특점。결과：36례중상규 MRI、SWI 화 FLAIR 서렬검출적뇌실질미출혈조분별위80、197화65개，검출적경막하혹외출혈분별위45、45화44개부위，검출적 SAH 분별위7、10화13례，분별검출4、7화4례환인존재뇌실내출혈。재검출뇌실질미출혈중，SWI 여상규 MRI（χ2＝166．419，P ＝0．001）화 FLAIR 서렬（χ2＝198．504，P ＝0．001）간차이유통계학의의（P ＜0．05）。재검출 SAH 방면，FLAIR 서렬여상규 MRI 서렬간차이유통계학의의（P ＝0．015）。로내출혈적신호특점교복잡， SWI 도상상로내출혈，우기시경막하혹외출혈，가이표현위고신호혹혼잡신호。결론：SWI 교상규 MRI 화 FLAIR 서렬능발현경다적미출혈조급뇌실내출혈，FLAIR 서렬재검출 SAH 방면구유독특적우세，종합응용 MRI 소묘서렬대우인동창상성로내출혈적진단급예후적판단유흔고적개치。
Objective:To investigate the value of MR susceptibility weighted imaging (SWI)and fluid attenuated in-version recovery (FLAIR)sequence in the diagnosis of children with traumatic intracranial hemorrhage.Methods:A total of 36 pediatric patients with traumatic brain injury and the age ranged from 3d~9y [(mean=2.6 ±2.6)y]were enrolled in this study.All patients underwent FLAIR sequence and SWI along with conventional MRI (cMRI)examination (including T1 WI,T2 WI)by a 3.0T MR scanner.The differences of the 3 approaches in displaying the volume of intracranial hemor-rhage including cerebral micro-bleeding (CMBs),subdural/extradural hemorrhage (SDH/EDH),subarachnoid hemorrhage (SAH)and intraventricular hemorrhage (IVH)were compared,and the signal characteristics of various intracranial hemor-rhage were analyzed.Results:Of the 36 patients,cMRI,SWI and FLAIR detected 80,197 and 65 lesions of micro-bleeding respectively;45,45,44 lesions of SDH or EDH respectively;7,10,13 cases of SAH and 4,7,4 cases with IVH respectively. In detecting microbleeding,there was significant difference between SWI and cMRI (P =0.001,χ2 =166.419),as well as between SWI and FLAIR (P =0.001,χ2 =198.504).In detecting SAH,there was statistical difference between FLAIR and cMRI (P =0.015).The signal appearances of intracranial hemorrhage were very complicated,and the hemorrhage signal es-pecially for SDH/EDH on SWI was either hyper-intensity or heterogeneous.Conclusion:When compared with cMRI and FLAIR,SWI can detect much more intra-cerebral micro-bleeding and IVH.FLAIR has obvious advantages superior to cMRI in detecting SAH.Thus,the use of comprehensive MRI sequences has significant value in the diagnosis and prognosis pre-diction for children with traumatic intrcracranial hemorrhage.