磁共振弥散张量成像在创伤性脑损伤临床诊断和预后评估的应用价值  

The value of diffusion tensor MR imaging in the clinical diagnosis and prognosis of traumatic brain injury

作　　者：陈水斌 汤奕林 欧阳林[1] 罗爱芳 肖玉辉[1] CHEN Shuibin;TANG Yilin;OUYANG Lin;LUO Aifang;XIAO Yuhui(Department of Imaging,909th Hospital of the Joint Logistics Support Force of PLA(Institute of Medical Imaging of Medical Colloge,Xiamen University),Zhangzhou 363000,P.R.China)

机构地区：[1]中国人民解放军联勤保障部队第九〇九医院医学影像科厦门大学医学院医学影像研究所,福建漳州363000

出　　处：《医学影像学杂志》2020年第10期1765-1769,共5页Journal of Medical Imaging

基　　金：福建省漳州市科技计划项目(编号:ZZ2016J02);中国博士后科学基金特别资助项目(编号:2015T81135);南京军区医学科技创新课题(编号:ZX20)。

摘　　要：目的探讨磁共振弥散张量成像(DTI)在创伤性脑损伤(TBI)临床诊断和预后评估中的应用价值。方法15例有明确颅脑外伤患者为TBI组,均行头颅CT、常规MRI序列(包括T 1WI、T 2WI、FLAIR像)与DTI检查,测量脑内不同部位的FA值,并对患者脑外伤严重程度行格拉斯哥昏迷评分(GCS),评估患者病情严重程度;采用Pearson直线相关分析FA值与GCS评分,分析患者后遗症的发生与DTI、GCS评分和住院时间的相关性,选取志愿者15例为对照组。结果TBI组各ROI的FA值与对照组相比较均下降,差异有统计学意义(P<0.05);TBI组双侧相同解剖部位FA值差异无统计学意义(P>0.05);TBI组的FA值与GCS存在明显相关性(P<0.05)。DTI异常与患者脑伤后遗症比较(P<0.05)为差异有统计学意义。结论FA值的变化与TBI患者的病情严重程度具有较强的相关性,DTI检查技术为临床TBI患者的早期确诊和病情严重程度的评估提供重要临床依据。Objective To investigate the value of diffusion tensor imaging(DTI)in the clinical diagnosis and prognosis of traumatic brain injury.Methods 15 patients with definite craniocerebral trauma were examined by CT,MRI(including T 1WI,T 2WI,FLAIR)and DTI.FA values of different parts of the brain were measured.Glasgow Coma Score(GCS)was used to evaluate the severity of the patients'brain injury.Pearson linear correlation analysis was used to analyze FA and GCS scores to explore the occurrence of the patients'sequelae correlation with DTI,GCS score and length of stay.Results The FA value of each ROI in TBI group was lower than that in the control group(P<0.05);there was no significant difference in FA value of the same anatomical site in both sides of TBI group(P>0.05);there was significant correlation between FA value and GCS in TBI group(P<0.05).DTI abnormality was significantly correlated with the sequelae of brain injury(P<0.05).Conclusion There is a strong correlation between the change of FA value and the severity of TBI patients.DTI provides an important clinical basis for the early diagnosis and the assessment of the severity of TBI patients.

关 键 词：创伤性脑损伤 磁共振成像 弥散张量成像 临床价值 

分 类 号：R651.1[医药卫生—外科学] R445[医药卫生—临床医学]