磁共振磁敏感加权成像在轻型颅脑损伤诊断中的应用研究  

Application of SWI in the diagnosis of mild traumatic brain injury

作　　者：陈狄洪[1] 任方远[1] 汪鑫斌 楼存诚[1] 王灿云[1] 刘源 Chen Dihong;Ren Fangyuan;Wang Xinbin;Lou Cuncheng;Wang Canyun;Liu Yuan(Department of Radiology,the First People's Hospital of Xiaoshan District,Hangzhou,Zhejiang 311201,China)

机构地区：[1]杭州市萧山区第一人民医院放射科,浙江省杭州311201

出　　处：《中国基层医药》2018年第23期3046-3049,3129,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省杭州市科技计划引导项目(20163501Y63).

摘　　要：目的探讨磁敏感加权成像(SWI)对轻型颅脑损伤(MTBI)患者中诊断价值。方法回顾性分析杭州市萧山第一人民医院2016年6月至2017年10月收治的轻型颅脑损伤患者[格拉斯哥昏迷量表(GCS)评分13~15分]89例的临床资料,所有患者入院后1周内给予头颅CT、MRI及SWI检查,分别记录CT、MRI、SWI图像上检测到的病灶部位、数目、大小,并按有无临床症状、有无昏迷病史进行分组分析。结果在有无临床症状、有无昏迷史分组中SWI成像对颅脑外伤微出血灶的检出率为94.4%、54.2%、100.0%、95.5%,高于CT检出率16.6%、4.2%、15.0%、4.5%和MRI常规序列扫描检出率33.3%、8.3%、20.0%、13.6%,差异均有统计学意义(χ^2=6.633,P=0.010;χ^2=4.260,P=0.039,均P<0.05),特别是在外伤后有短暂昏迷病史的MTBI患者中阳性率(100.0%)更高。结论SWI成像对轻型颅脑外伤的微挫裂伤及小出血灶的显示,较常规CT与MRI具有更高的准确性和重要的诊断价值,对临床上治疗及判断MTBI患者的预后有重大意义。Objective To investigate the diagnostic value of susceptibility weighted imaging(SWI) in patients with mild traumatic brain injury(MTBI).Methods From June 2016 to October 2017,a retrospective analysis of 89 patients with MTBI (Glasgow score 13 to 15) in the First People's Hospital of Xiaoshan District was conducted.All patients were given head CT,MRI and SWI within 1 week after admission.Combined with CT and phase diagram,after removing blood vessels,calcification and skull base artifact,the low signal intensity on the SWI was cerebral contusion and hemorrhage.The sites,the number and the size of lesion detected on CT,MRI and SWI images were recorded and analyzed with clinical symptoms.Results According to the presence or absence of clinical symptoms in the group,the detection rates of microbleeds hemorrhage in patients with traumatic cerebral by SWI were 94.4%,54.2%,100.0%,95.5%,respectively,which were higher than those by CT(16.6%,4.2%,15.0%,4.5%) and MRI conventional sequences(33.3%,8.3%,20.0%,13.6%),the differences were statistically significant(χ^2=6.633,P=0.010; χ^2=4.260,P=0.039,all P<0.05),especially in MTBI patients with a history of transient coma or persistent clinical symptoms after trauma(the detection rate was 100.0%).Conclusion Compared with conventional CT and MRI,the micro-contusion and small hemorrhagic lesions of SWI is more accurate and important in the diagnosis of MTBI,and has a significant prognostic value for clinical treatment and judgment of patients with MTBI.

关 键 词：颅脑损伤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R445.2[医药卫生—影像医学与核医学]