磁共振功能成像技术在硬膜外和硬膜下血肿中的临床应用研究  

The clinical application of magnetic resonance imaging technology in the epidural and subdural hematoma

作　　者：黄波涛[1] 金新安[1] 曾焕忠[1] 杨兴桂[1] 王斌[1] 陈伟[1] 

机构地区：[1]广东医学院附属厚街医院放射科,广东东莞523945

出　　处：《牡丹江医学院学报》2015年第3期7-10,共4页Journal of Mudanjiang Medical University

基　　金：东莞市医疗卫生科技计划项目(20131051010149)

摘　　要：目的探讨磁共振弥散加权成像(DWI)和灌注加权成像(PWI)在急性外伤性幕上硬膜外和硬膜下血肿中的临床应用价值。方法选择80例根据CT检查血肿体积小于40m L的尚无明显意识障碍或颅内压增高症状的急性幕上单纯硬膜外或硬膜下血肿病例,随机分为实验组和对照组。实验组:于发病6小时内行磁共振常规系列、DWI和PWI检查,观察血肿周围微循环变化,存在缺血半暗带者行手术治疗,其余行保守治疗。对照组:行保守治疗。两组病例治疗半年后复查磁共振常规系列,观察脑组织情况。结果实验组:40例患者中22例存在缺血半暗带行手术治疗,其余18例行保守治疗;治疗后复查磁共振共发现局部后遗病灶6例。对照组保守治疗后复查磁共振发现局部后遗病灶21例。两组经过χ2检验,χ2=13.09,P<0.005,两者差异有统计学意义。结论联合应用磁共振PWI和DWI能检测血肿周围脑组织是否存在缺血半暗带,为急性幕上单纯硬膜外或硬膜下血肿患者是否需及时采用手术治疗提供客观、精确的判断标准,较传统的手术指征更具有可行性和准确性。Objcetive To explore the clinical application value of magnetic resonance diffusion weighted imaging （ DWI ） and perfusion weighted imaging（ PWI） in patients with the tent of acute epidural and subdural hematoma .Meth ods 80 patients who were diagnosed with acute epidural on screen or a subdural hematoma with hematoma volume less than 40ml according to CT examination , and no obvious disturbance of consciousness or increased intracranial pressure symptoms , were included in this study and randomly di-vided into experimental group and control group .Experimental group：All cases were checked in 6 hours after the onset of disease with MRI conventional series , DWI and PWI.The microcirculation changes around hematoma were observed , the cases with existence of is-chemia half dark were treated surgically , and other cases were treated with conservative treatment .Control group：conservative treat-ment .Two groups of cases were checked by MRI after half a year .Results The experimental group：22 cases with ischemia half dark of 40 patients were treated with surgical treatment , and the remaining 18 cases were treated with routine conservative treatment;6 cases were found with local lesion by reviewing magnetic resonance imaging after surgical treatment .The control group：21cases were found with local lesion by reviewing magnetic resonance imaging after conservative treatment .The occurrence of local lesion in experimental group was significantly lower than that in control group （χ2 =13.09, P〈0.005）.Conlc usion Combined using of magnetic reso-nance PWI and DWI could detect the presence of ischemia and half dark in brain tissue around hematoma , which could provide objec-tive and accurate judgment standard for timely surgery needed by acute epidural or subdural hematoma patients , and which could be more feasible than the traditional surgical indications and accuracy .

关 键 词：磁共振成像 硬膜外血肿 硬膜下血肿 

分 类 号：R8[医药卫生—临床医学]