CAJ | 학술논문

目的：通过核磁共振扩散张量成像(diffusion tensor imaging, DTI)评估轻型颅脑损伤患者颅内损伤情况，探讨DTI在轻型颅脑损伤患者诊断中的应用价值。材料与方法收集CT检查未见出血及骨折的轻型颅脑损伤患者30人，正常对照组30人。在受伤后7天内，行头部MRI检查，并在行头MRI检查当天用Rivermead脑震荡后综合征评估表进行评分。结果轻型颅脑损伤组Rivermead脑震荡后综合征评分高于对照组。轻型颅脑损伤组FA值升高区域有：右侧小脑半球、右侧枕叶及小脑山坡，舌回，右侧额下回的三角部，楔前叶灰质。轻型颅脑损伤组FA值降低区域有：视辐射，大脑脚，右侧胼胝体膝，左侧胼胝体膝，右侧额中回下白质，中央前回下白质。结论轻型颅脑损伤患者存在器质性颅内改变。扩散张量成像对于轻型颅脑损伤造成的颅内病变非常敏感，可以为临床诊断轻型颅脑损伤提供参考依据，并为判断轻型颅脑损伤预后提供一定帮助。
목적：통과핵자공진확산장량성상(diffusion tensor imaging, DTI)평고경형로뇌손상환자로내손상정황，탐토DTI재경형로뇌손상환자진단중적응용개치。재료여방법수집CT검사미견출혈급골절적경형로뇌손상환자30인，정상대조조30인。재수상후7천내，행두부MRI검사，병재행두MRI검사당천용Rivermead뇌진탕후종합정평고표진행평분。결과경형로뇌손상조Rivermead뇌진탕후종합정평분고우대조조。경형로뇌손상조FA치승고구역유：우측소뇌반구、우측침협급소뇌산파，설회，우측액하회적삼각부，설전협회질。경형로뇌손상조FA치강저구역유：시복사，대뇌각，우측변지체슬，좌측변지체슬，우측액중회하백질，중앙전회하백질。결론경형로뇌손상환자존재기질성로내개변。확산장량성상대우경형로뇌손상조성적로내병변비상민감，가이위림상진단경형로뇌손상제공삼고의거，병위판단경형로뇌손상예후제공일정방조。
Objective: The purpose of this study was to detect intracranial axonal damage after mild traumatic brain injury using diffusion tensor imaging (DTI), and assess the application of DTI in mild traumatic brain injury clinically. Materials and Methods:Thirty patients were prospectively enrolled from Tianjin First Center Hospital, who sustained a mild TBI, 30 normal volunteers were also recruited as control. All the participants underwent routine MRI, DTI scanning, and Rivermead Post Concussion Symptoms Questionnaire (RPQ) within the day of examination. Results:The RPQ scores of mTBI patients were higher than control (P<0.01). Whole brain analysis of DTI revealed the areas with higher FA values: right cerebellum, occipital lobe, declive, lingual gyrus, the triangular part of right inferior frontal gyrus, Precuneus. The areas with lower FA values were the optic radiation, cerebral peduncle, corpus callosum, the white matter under middle frontal gyrus, the white matter under precentral gyrus. Conclusion:We had shown that DTI can identify abnormalities in patients following mTBI. DTI were sensitive in finding intracranial latent lesion by mTBI. We believed such early identiifcation could certainly be used to help diagnosis, and might play a key role in prognosis of mTBI.