3．0T磁敏感加权成像在出血性弥漫性轴索损伤中的诊断价值  

Value of 3.0 T susceptibility weighted imaging in diagnosis of hemorrhagic diffuse axonal injury

作　　者：赵秀芹[1] 狄玉进[1] 徐金法[1] 白敏[1] 布春青[1] 李淑华[1] 

机构地区：[1]聊城市人民医院磁共振室,252000

出　　处：《中华创伤杂志》2012年第9期790-793,共4页Chinese Journal of Trauma

摘　　要：目的探讨磁敏感加权成像（susceptibility weighted imaging，SWI）在出血性弥漫性轴索损伤（diffuseaxonalinjury，DAI）中的诊断价值。方法回顾性分析20例外伤后3d内行MRI检查的DAI患者的资料，扫描序列包括T1WI、T2WI、液体衰减反转恢复（fluidattenuatedinver—sionrecovery，FLAIR）序列和扩散加权成像（diffusionweightedimaging，DWI）及SWI扫描。GCS≤8分15例，9～12分3例，13～15分2例；统计病灶的发生部位、数量，测量各扫描序列发现的病灶面积，应用x。检验比较各序列病灶检出率的差异，并对患者DAI出血灶面积与GCS评分作相关分析。结果DAI出血灶在脑表浅部位较后颅窝和脑深部多，SWI序列对出血性病灶的检出率最高，与其他序列的差异有统计学意义（P〈0．05），出血灶的面积与GCS评分呈负相关（r=-0．921，P〈0．01）。结论SWI能非常敏感地检出外伤后急性期DAI患者的脑内出血灶。Objective To investigate the value of susceptibility weighted imaging （SWI） in the diagnosis of hemorrhagic diffuse axonal injury （DAI）. Methods A retrospective study was conducted on 20 patients with DAI who received MRI examination at day 3 post-injury. MRI sequences included T1WI, T2WI, fluid attenuated inversion recovery （FLAIR）, diffusion weighted imaging （DWI） and SWI. There were 15 patients with the Glasgow Coma Scale （GCS） score≤8, three with GCS score of 9- 12 and two with GCS of 13-15. The location and quantity of hemorrhage focus were counted. The area of hemorrhage focus was measured on each MR sequence. Differences of detection rate of hemorrhage focus on each sequence were compared by using X2 test. The correlation between DAI related bleeding area and GCS score was analyzed. Results DAI related hemorrhage focus showed a larger number in superficial cerebrum than that in posterior cranial fossa and in deep cerebrum. The detection rate of hemorrhage focus on SWI was the highest, as compared with other sequences （ P 〈 0.05 ）. Bleeding area and GCS score showed a negative correlation （ r = -0. 921, P 〈 0.01 ）. Conclusion SWI is very sensitive in detection of the intracerebral hemorrhage focus in the acute period of traumatic DAI.

关 键 词：弥漫性轴索损伤 磁共振成像 脑损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学]