隐匿性小灶性脑挫伤的多模态影像诊断及临床应用价值  

Multimodal Imaging Diagnosis and Clinical Application of Occult Mini-Focal Brain Contusion

作　　者：杨先春[1] 陈莉[2] 左敏[1] 刘长华[1] 吴汉斌[1] 杨克勤[1] 王弘[3] YANG Xianchun;CHEN Li;ZUO Min(Department of Radiology,Hanyang Hospital Affiliated to University of Science and Technology in Wuhan,Hubei Province 430050,P.R.China)

机构地区：[1]武汉科技大学附属汉阳医院放射科,430050 [2]武汉科技大学附属汉阳医院消化内科,430050 [3]鄂东医疗集团黄石市中心医院放射影像科,黄石435000

出　　处：《临床放射学杂志》2019年第11期2042-2046,共5页Journal of Clinical Radiology

基　　金：湖北省武汉市卫生健康委员会科研项目《1.5 MRI-SWI对急性隐匿性小灶性脑挫伤的诊断价值》面上项目基金资助(编号WX17D25)

摘　　要：目的探讨隐匿性小灶性脑挫伤(OMBC)的多模态影像诊断及其临床应用价值。方法回顾性分析2016年12月至2018年12月期间经CT和MRI诊断的35例OMBC患者的影像和临床资料,总结OMBC的临床特征、影像学表现,比较各种影像学检查的诊断效能。结果 49例外伤患者中发现OMBC 35例,共226枚病灶,其中CT随访复查发现15例共21枚病灶,MRI常规序列扫描共发现29例80枚病灶,扩散加权成像(DWI)序列扫描发现32例98枚病灶,磁敏感加权成像(SWI)序列扫描发现31例206枚病灶。CT随访复查的敏感度、特异度、准确率分别为9.29%、55.00%、13.0%,MRI常规序列分别为32.5%、45.00%、36.18%,DWI序列分别为77.77%、45.00%、43.50%,SWI序列分别为91.15%、35.00%、86.59%,多模态影像分别为91.86%、85.00%、98.78%。五种检查方式对急性OMBC诊断比较,CT联合MRI多模态影像诊断效能最高。结论 OMBC的CT和MRI表现有一定的影像学特征;CT联合MRI多模态影像诊断可以明显提高OMBC的敏感度。OMBC的早发现有助于患者的及时治疗和良好预后。Objective To investigate the multimodal image diagnosis of occult small focal cerebral contusion and its clinical application value. Methods The imaging and clinical data of 35 cases of occult small focal cerebral contusion diagnosed by CT and MRI from December 2016 to December 2018 were retrospectively analyzed. The clinical features,imaging findings and comparison of occult small focal cerebral contusion were summarized. Results A total of 226 lesions were found in 35 patients with occult small focal cerebral contusion. Among them,follow up CT examination was done for a total of 21 lesions in 15 cases. A total of 29 lesions were found in MRI routine sequence scans. In 32 cases of 98 lesions,31 cases of 206 lesions were found by SWI sequence scanning. The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CT follow-up review,MRI routine sequence scan,DWI sequence,SWI sequence and multimodal image were 9.29%,55.00%,13.0%,and 32.5%,respectively. 45.00%,36.18%;77.77%,45.00%,43.50%;91.15%,35.00%,86.59%;91.86%,85.00%,98.78%. Five kinds of examination methods were used to compare the diagnosis of acute occult small focal cerebral contusion. P<0.05 showed that the difference was statistically significant. Conclusion CT and MRI imaging findings of occult small focal cerebral contusion have certain imaging features. CT combined with MRI multimodal imaging diagnosis can significantly improve the sensitivity of occult small focal cerebral contusion. Early detection and early treatment of occult small focal cerebral contusion can help patients with timely treatment and good prognosis.

关 键 词：小灶性脑挫伤 隐匿性 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R651.15[医药卫生—诊断学] R816.1[医药卫生—临床医学]