CAJ | 학술논문

目的探讨弥散加权成像(DWI)联合磁敏感加权成像(SWI)对脑创伤性轴索损伤(TAI)病灶的检出及在预后评估中的价值. 方法回顾性分析75例TAI患者临床影像资料,平均年龄(71.7±11.5)岁,比较磁共振各序列对TAI病灶的检出数,多因素Logistic回归分析DWI联合SWI的影像学指标和临床指标与患者伤后6个月格拉斯哥预后评分(GOS)的相关性. 结果 75例DWI和SWI脑内TAI病灶平均检出数分别为(19.92±8.62)个、(22.17±11.72)个,两者间差异无统计学意义(t=l.24,P＞0.05),与磁共振常规序列比较均差异有统计学意义(P＜0.05).DWI对非出血性水肿病灶最为敏感,SWI对出血性病灶最为敏感,但两者检出病灶部分存在着损伤部位和病理性质的重叠.(2) DWI与SWI脑中轴部位病灶数在预后良好组与不良组间差异均有统计学意义(t=2.455,P＜0.05).Logistic逐步回归分析显示两者脑中轴非重叠病灶数之和与临床相关因素结合后预测预后的准确率达95.7％. 结论 DWI和SWI均为TAI病灶检出的敏感序列,可分别检出不同病理学特性的病灶.两者影像学检查结果与临床因素相结合后可对TAI患者做出预后评估提供一定的依据.
목적 탐토미산가권성상(DWI)연합자민감가권성상(SWI)대뇌창상성축색손상(TAI)병조적검출급재예후평고중적개치. 방법 회고성분석75례TAI환자림상영상자료,평균년령(71.7±11.5)세,비교자공진각서렬대TAI병조적검출수,다인소Logistic회귀분석DWI연합SWI적영상학지표화림상지표여환자상후6개월격랍사가예후평분(GOS)적상관성. 결과 75례DWI화SWI뇌내TAI병조평균검출수분별위(19.92±8.62)개、(22.17±11.72)개,량자간차이무통계학의의(t=l.24,P＞0.05),여자공진상규서렬비교균차이유통계학의의(P＜0.05).DWI대비출혈성수종병조최위민감,SWI대출혈성병조최위민감,단량자검출병조부분존재착손상부위화병이성질적중첩.(2) DWI여SWI뇌중축부위병조수재예후량호조여불량조간차이균유통계학의의(t=2.455,P＜0.05).Logistic축보회귀분석현시량자뇌중축비중첩병조수지화여림상상관인소결합후예측예후적준학솔체95.7％. 결론 DWI화SWI균위TAI병조검출적민감서렬,가분별검출불동병이학특성적병조.량자영상학검사결과여림상인소상결합후가대TAI환자주출예후평고제공일정적의거.
Objective To explore the value of diffusion weighted imaging (DWI) in combination with susceptibility weighted imaging (SWI) in prognosis prediction of traumatic axonal injury (TAI).Methods A retrospective study of 75 patients with TAI was performed to analyze the clinical data and the follow-up prognosis in the 6 months after injury.The detection rate of TAI lesion by DWI,SWI and conventional MRI was compared.Multiple factors analysis applied logistic regression analysis to analyze the relationship between associated factors and prognosis.Results The average detected TAI lesions were (19.92 ± 8.62) by DWI and (22.17 ± 11.72) by SWI,which had no significant differences (t=1.24,P＞0.05),but there was a significant difference bettween by conventional MRI and by DWI or SWI (all P＜0.05).DWI was more sensitive to non-hemorrhagic lesions and SWI was more sensitive to hemorrhagic lesions.However,the lesions revealed by them existed the overlap of location and pathology of lesions.Patients with poor outcomes had more number of central lesions than those patient with good outcomes (t=2.455,P＜ 0.05).Logistic regression analysis revealed that the predictive accuracy provided by the combination with imaging and clinical factors was 95.7 ％.Conclusions DWI and SWI both are sensitive to TAI lesions,and have ability to detect the lesions with different pathological characteristics,separately.Accurate prognosis prediction for patients with TAI may be provided by the combination of clinical and imaging factors.