脑弥漫性轴索损伤患者颅脑CT和MRI表现及其与病情严重程度的关系  

CT and MRI manifestations of the brain in patients with diffuse axonal injury and its relationship with the severity of the disease

作　　者：张军强 杜红艳 刘连锋 赵明增 ZHANG Junqiang;DU Hongyan;LIU Lianfeng;ZHAO Mingzeng(Xianyang Hospital of Yan'an University,Xianyang 712000;Xianyang Qindu Puhui Clinic Branch,Xi'an Puhui Health Examination Co.,Ltd,Xianyang 712000;Xi'an XD Group Hospital,Xi'an 710077,China)

机构地区：[1]延安大学咸阳医院,陕西咸阳712000 [2]西安普惠健康体检有限公司咸阳秦都普惠门诊分公司,陕西咸阳712000 [3]西电集团医院,陕西西安710077

出　　处：《临床医学研究与实践》2020年第35期136-138,共3页Clinical Research and Practice

基　　金：陕西省医学科研项目(陕卫验证字[2018]第027号)。

摘　　要：目的探讨脑弥漫性轴索损伤患者颅脑CT和MRI表现及其与病情严重程度的关系。方法选取2018年1月至2019年8月收治的44例脑弥漫性轴索损伤患者为研究对象,所有患者均接受颅脑CT及MRI检查,观察脑弥漫性轴索损伤的影像学表现,并分析其与病情严重程度的关系。结果44例脑弥漫性轴索损伤患者表现为弥漫性脑肿胀44例,脑实质内出血灶32例,蛛网膜下腔和/或脑室出血27例,脑干损伤15例,合并硬膜下血肿13例,合并硬膜外血肿11例,合并颅骨骨折12例。相较于无脑干损伤患者,脑干损伤患者GCS评分明显更低,昏迷时间明显更长,预后不良率显著更高(P<0.05),且经Spearman相关性分析显示,颅脑CT及MRI脑干损伤表现与病情严重程度呈显著正相关(r=0.784,P<0.05)。结论脑弥漫性轴索损伤患者颅脑CT及MRI表现能够有效反映其损伤情况,脑干损伤与患者病情严重程度存在显著相关性。Objective To investigate the CT and MRI manifestations of brain in patients with diffuse axonal injury and its relationship with the severity of the disease.Methods Forty-four patients with diffuse axonal injury from January 2018 to August 2019 were selected as the research objects,and all patients underwent CT and MRI examinations of the brain.The imaging findings of diffuse axonal injury were observed,and the relationship between the imaging findings and the severity of the disease was analyzed.Results Forty-four patients with diffuse axonal injury showed diffuse brain swelling in 44 cases,intracerebral hemorrhage in 32 cases,subarachnoid and/or ventricular hemorrhage in 27 cases,brain stem injury in 15 cases,subdural hematoma in 13 cases,epidural hematoma in 11 cases and skull fracture in 12 cases.Compared with the patients without brain stem injury,the GCS score of patients with brain stem injury was significantly lower,the coma time was significantly longer,and the poor prognosis rate was significantly higher(P<0.05).Spearman correlation analysis showed that brain stem injury performance of brain CT and MRI was significantly positively correlated with the severity of the disease(r=0.784,P<0.05).Conclusion The CT and MRI manifestations of the brain of patients with diffuse axonal injury can effectively reflect the injury situation,and there is a significant correlation between brain stem injury and the severity of the disease.

关 键 词：脑弥漫性轴索损伤 CT MRI 脑干损伤 病情严重程度 

分 类 号：R651.15[医药卫生—外科学] R816.1[医药卫生—临床医学]