弥散张量成像诊断弥漫性轴索损伤的敏感性及意识状态的研究  

Sensitivity of diffusion tensor imaging in diagnosing diffuse axon damage and degree of coma

作　　者：刘克君[1] 荆国杰[1] 姚晓腾[1] 景英朝[1] 李毅毅[1] 李王安[1] 谢乙团[1] 赵冬青[1] 李百升[2] 

机构地区：[1]惠州市第一人民医院神经外科,惠州市神经外科研究所,516001 [2]惠州市中心人民医院神经外科,516000

出　　处：《中华神经医学杂志》2013年第9期944-946,共3页Chinese Journal of Neuromedicine

基　　金：广东省自然科学基金（10151600101000002）

摘　　要：目的研究弥散张量成像（DTI）诊断弥漫性轴索损伤（DAI）的敏感性，及探讨中脑区各向异性分数（FA）值与GCS评分的相关性以定量评估DAI的损伤程度。方法选择惠州市第一人民医院及惠州市中心人民医院神经外科自2007年1月至2013年1月临床诊断为DAI的105例患者为研究对象，对其在入院时行CT、MRJ平扫及DTI扫描，观察比较3种不同影像学方法检测DAI损伤病灶的敏感性差异，并分析其中36例DAI患者中脑区FA值与人院时GCS评分的相关性。结果CT检测DAI损伤病灶的敏感性为70．48％，MR／平扫为82．86％，DTI为95．24％．3者比较差异具有统计学意义（P〈0．051，其中以DTI检查诊断的敏感性为最高。患者人院时GCS评分与中脑区FA值存在正相关关系（r=0．977，P=0．000）。结论DTI不仅在诊断DAI敏感性方面优于CT和MRI平扫，且在一定程度上可客观地评估DAI的损伤程度。Objective To study the sensitivity of diffusion tensor imaging （DTI） in diagnosing diffuse axon injury （DAI） and research the correlation between fractional anisotropy （FA） values of midbrain and Glasgow coma scale （GCS） scores to quantitative evaluate DAI. Methods One hundred and five patients with DAI, admitted to our hospital from 2007 to 2013, were chosen in our study; their imaging data, including X-ray computed tomography （CT） scan, magnetic resonance imaging （MR_I） conventional scan and DTI scan at admission, were observed, and the sensitivity of three imaging methods in detecting DAI damage lesions was compared; the correlation between FA values in the midbrain and GCS scores of 36 DAI patients was analyzed. Results The sensitivity of CT in detecting DAI damage lesions was 70.48%, that of MRI conventional scan was 82.86% and that of DTI scan was 95.24% with significant difference among the three groups （P〈0.05）. Significant positive correlation was noted between GCS scores and FA values of midbrain areas （r=0.977, P=0.000）. Conclusion As to DTI in the diagnosis of DAI, not only its sensitivity is superior to CT and MR/scan, but also in a certain extent it can objectively evaluate the injury extent of DAI.

关 键 词：弥漫性轴索损伤 弥散张量成像 敏感性 各向异性分数 格拉斯哥昏迷评分 

分 类 号：R651.15[医药卫生—外科学]