脑弥漫性轴索损伤的MRI征象及与GCS计分及预后的关系  

Relationships between MRI Sign and GCS, Clinical Prognosis in Patients with Diffuse Axonal Injury

作　　者：李洲[1] 李建军[1] 邢增宝[1] 王飞[1] 陈峰[1] 陈旺生[1] 李长清[1] 

机构地区：[1]海南省人民医院放射科,海南海口570311

出　　处：《现代生物医学进展》2015年第21期4135-4138,共4页Progress in Modern Biomedicine

基　　金：海南省卫生厅资助课题(琼卫2012PT-20)

摘　　要：目的:探讨脑弥漫性轴索损伤(DAI)的磁共振成像(MRI)征象及其与格拉斯哥昏迷量表评分(GCS)计分和预后的关系。方法:回顾性分析2012年1月-2014年7月我院收集的30例DAI患者的临床病历资料,根据病灶累及部位分析其与GCS计分和临床预后的关系。结果:30例患者共53个病灶,17例多发病灶,13例单发病灶;42个病灶T1WI显示出低信号或者是等信号,11个病灶T1WI显示为高信号;T2WI显示为高信号,FLAIR序列以及弥散加权像(DWI)上表现出的信号更高,范围更清晰;病灶形态呈条索状27例,斑片状11例,卵圆形8例,不规则斑点状7例;病灶未累及脑中线部位的患者临床预后优于病灶累及脑中线部位的患者,差异有统计学意义(Z=-2.636,P=0.008),病灶累及脑中线部位的患者GCS计分情况比未累及组严重,计分更低,差异有统计学意义(Z=-2.519,P=0.012)。结论:DAI病灶累及脑中线部位的患者GCS计分较低、预后差,MRI检查是诊断DAI首选的影像学方法,临床有重要的参考价值。Objective： To investigate the MRI sign in patients with diffuse axonal injury （DAD and its relationship with Glasgow Coma Scale（GCS） and clinical prognosis. Methods： A total of clinical data of 30 patients with DAI,who were admitted to the department of cerebral surgery in our hospital from January 2012 to July 2014, were retrospectively analyzed,and according to the lesion site of in- volvement, its relationships with GCS and clinical prognosis were evaluated. Results： There were a total of 53 lesions in the 30 patients with DAI,among which,there were 17 with multiple lesions and 13 with single lesion. T1WI of 42 lesions showed low or equal signals; while T1WI of 11 lesions showed high signals. High signal was indicated in T2WI and higher signal and higher imaging were showed on the FLAIR sequence and diffuse weighted imaging （DWI）. The lesions showed different forms： 27 cases of cords, 11 cases of patchy, 8 cases of oval and 7 cases of irregular mottled lesions. The clinical prognosis of patients whose lesions did not involve the brain midiine was superior to that of patients whose lesions involved the brain midline, with statistical significance（Z=-2.636,P=0.008）. The GCS score in patients whose lesions involved the brain midiine was lower than that in patients whose lesions didn＇t involve the brain midline, with statistical significance（Z=-2.519, P=0.012）. Conclusion： The patients with DAI whose lesions involved the brain midiine have lower GCS score and poor prognosis. So for the patients with DAI, MRI examination is the preferred imaging diagnosis methodology, which can be used for the clinical reference.

关 键 词：脑弥漫性轴索损伤 核磁共振成像 GCS计分 临床预后 

分 类 号：R651[医药卫生—外科学] R445.2[医药卫生—临床医学]