T2FLAIR与GRE-T2^＊WI对诊断创伤性颅内脑外出血的比较研究  

Comparison of T2 FLAIR and GRE-T2^＊ WI in detection of traumatic extra-axial hemorrhage

作　　者：武春雪[1,2] 马军[2] 金鹤[2] 刘佰运[3] 陶晓刚[3] 田润发[3] 

机构地区：[1]北京市神经外科研究所,北京100050 [2]首都医科大学附属北京天坛医院放射科 [3]首都医科大学附属北京天坛医院神经外科

出　　处：《实用放射学杂志》2016年第3期331-334,共4页Journal of Practical Radiology

基　　金：卫生部卫生行业科研专项项目（201402019）.

摘　　要：目的探讨液体衰减反转恢复（FLAIR）序列与梯度回波T2^＊加权（GRE-T2^＊WI）序列对急性创伤性颅内脑外出血诊断的价值。方法50例CT平扫发现的急性创伤性颅内脑外出血患者，于急性期同时行FLAIR序列及GRE-T2^＊WI序列检查，分析比较两者对蛛网膜下腔出血（SAH）、硬膜外出血（EDH）及硬膜下出血（SDH）诊断的总体一致性（Kappa）、总体检出率，并利用χ^2检验进一步比较FLAIR、GRE-T2^＊WI序列及结合2序列分别诊断8个部位SAH的差异。结果48例患者最终人组。48例SAH患者的FLAIR序列及GRE—T2^＊WI序列诊断总体一致性很高（k=1．0），总体检出率均为100％，各部位检出率与结合2序列诊断比较，FLAIR序列较GRE—T2^＊WI序列与结合2序列更容易误诊中脑周围池SAH（P值〈0．05）；3例EDH患者FLAIR序列及GRE-T2^＊WI序列诊断一致性很高（k=1．0），检出率均为100％；12例SDH患者诊断一致性较高（k=0．943），FLAIR序列检出率为100％，1例SDH患者GRE—T2^＊WI序列未能诊断。结论FLAIR序列与GRE-T2^＊WI序列对诊断急性创伤性颅内脑外出血的检出率均较高，2序列结合能够提高对急性创伤性颅内脑外出血诊断的准确性。Objective To explore the value of fluid-attenuated inversion recovery （FLAIR） sequence and gradient echo T2^＊ weighted image （GRE-T2^＊ WI） in diagnosis of acute traumatic extra-axial hemorrhage. Methods 50 patients who were diagnosed as acute traumatic extra-axial hemorrhage by plain CT underwent FLAIR and GRE-T2^＊ WI in acute stage. The diagnosis consistency （Kappa）, detection rate of subarachnoid hemorrhage （ SAH ）, epidural hemorrhage （ EDH ） and subdural hemorrhage （ SDH ） were compared. The detection rates of SAH in 8 locations among FLAIR,GRE-T2^＊ WI and combination of two sequences were analyzed by Chi-square test. Results 48 patients were enrolled in the study. The diagnosis consistency of SAH between FLAIR and GRE-T2^＊ WI was high （k=1.0）. The detection rate of SAH was 100% for both FLAIR and GRE-T2^＊ WI. Comparing with GRE-T2^＊ WI and combination of two sequences, FLAIR tended to misdiagnose SAH in perimesencephalic cistern （P〈0.05）. The diagnosis consistency of EDH between FLAIR and GRE-T2^＊ WI was high （k= 1.0）. 3 patients with EDH were all detected by FLAIR and GRE-T2^＊ WI. The diagnosis consistency of SDH between FLAIR and GRE-T2^＊ WI was high （k=0.943）. The detection rate of 12 patients with SDH was 100% in FLAIR, and 1 patient with SDH was missed by GRE-T2^＊ WI. Conclusion The detection rate of acute traumatic extra-axial hemorrhage is high for both FLAIR and GRE-T2^＊ WI. Combination of two sequences can improve the accuracy of acute traumatic extra-axial hemorrhage in clinic.

关 键 词：液体反转恢复序列 梯度回波 创伤性颅内脑外出血 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.34[医药卫生—诊断学]