基于磁共振多b值弥散加权成像对严重胸外伤预后的预测  

Prediction of the Prognosis of Severe Thoracic Trauma Based on MRI Multi-b-value Diffusion-weighted Imaging

作　　者：李智勇 惠珂[2] 薛旭涛 龚雪鹏 齐东海 张永昌[6] LI Zhi-yong;HUI Ke;XUE Xu-tao;GONG Xue-peng;QI Dong-hai;ZHANG Yong-chang(Xijing 986 Hospital,Militar Special Clinic Center,Forrth Military Medical University,Xi'an,Shaanxi,710054,China;Dept of Respiratory and Critical Care,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi,710068,China;Dept of Radiology,Xidian Group Hospital,Xi'an,Shaanxi,710077,China;Xijing 986 Hospital,Magnet Resnance Room,Fourth Military Medical University,Xi'an,Shaanxi,710054,China;Dept of Cardiothoracic Surgery,the 987th Hospital of the Joint Support Force of the People's Liberation Army,Baoji,Shaanxi,721000,China;Dept of Thoracic Surgery,Xi'an Fourth Hospital,Xi'an,Shaanxi,710004,China)

机构地区：[1]空军第九八六医院军人特诊中心,陕西西安710054 [2]陕西省人民医院呼吸与危重症二科,陕西西安710068 [3]西电集团医院放射科,陕西西安710077 [4]空军第九八六医院磁共振室,陕西西安710054 [5]解放军联勤保障部队第九八七医院心胸外科,陕西宝鸡721000 [6]西安市第四医院胸外科,陕西西安710004

出　　处：《现代生物医学进展》2021年第6期1081-1084,共4页Progress in Modern Biomedicine

基　　金：陕西省重点研发计划项目(2019SF-185)。

摘　　要：目的:探讨基于磁共振(Magnetic Resonance Imaging,MRI)多b值弥散加权成像(Diffusion Weighted Imaging,DWI)对严重胸外伤预后的预测价值。方法:2018年2月-2020年6月选择在本院诊治的严重胸外伤患者76例(开放性损伤38例,闭合性损伤38例),所有患者都给予常规MRI扫描、多b值DWI扫描,记录成像质量与特征,判断预测价值。结果:所有患者都在胸外伤后3 d内进行检查,开放性损伤与闭合性损伤患者的MRI图像质量优良率都为100.0%,符合诊断要求。开放性损伤患者的多b值DWI之D*值、f值都显著高于闭合性损伤患者,而D值显著低于闭合性损伤患者,对比差异都有统计学意义(P<0.05)。在76例患者中,病理判断为胸腔后方韧带复合体1级损伤38例,2级损伤30例,3级损伤8例。MRI诊断为1级损伤39例,2级损伤31例,3级损伤6例,MRI诊断的准确性为93.4%。结论:基于MRI多b值DWI能清晰显示严重胸外伤的组织损伤情况,也能真实反映组织的微环境变化特征,能有效预测后方韧带复合体的损伤情况。Objective:To explore the prognostic values of multi-b-value Diffusion Weighted Imaging(DWI)based on Magnetic Resonance Imaging(MRI)for the prognosis of severe chest trauma.Methods:From February 2018 to June 2020,76 cases of patients with severe chest trauma(38 cases of open injury and 38 cases of closed injury)were selected for diagnosis and treatment.All patients were given conventional MRI scans and multi-b value DWI scans,Recorded the imaging quality and characteristics,and judged the predictive values.Results:All patients were examined within 3 days after thoracic trauma.The excellent and good rates of MRI images of patients with open injury and closed injury were 100.0%,which met the diagnostic requirements.The multi-b value DWI D*value and f value of patients with open injury were significantly higher than those with closed injury,while the D value was significantly lower than that of patients with closed injury,and compared the difference were statistically significant(P<0.05).In the 76 patients,pathologically judged as the posterior thoracic ligament complex in 38 cases of grade 1 injury,30 cases of grade 2 injury,and 8 cases of grade 3 injury;MRI diagnosed 39 cases of grade 1 injury,31 cases of grade 2 injury,and 6 cases of grade 3 injury,and the accuracy of MRI diagnosis were 93.4%.Conclusion:Based on MRI multi-b value DWI can clearly show the tissue damage of severe thoracic trauma,it can also truly reflect the characteristics of tissue microenvironment changes,and can effectively predict the damage of the posterior ligament complex.

关 键 词：磁共振成像 B值 弥散加权成像 严重胸外伤 后方韧带复合体 

分 类 号：R655[医药卫生—外科学] R445.2[医药卫生—临床医学]