磁共振DTI成像技术在弥漫性轴索损伤临床诊断及病情评估中的应用研究  

Application of DTI in Clinical Diagnosis and Condition Evaluation of Diffuse Axonal Injury

作　　者：谢晶美 朱志敏[1] 陈苗苗[1] 郭宝琴[1] 刘浩[1] 李宏荣 XIE Jing-mei;ZHU Zhi-min;CHEN Miao-miao;GUO Bao-qin;LIU Hao;LI Hong-rong(Magnetic Resonance,The Second Hospital of Yulin City,Yulin 719000,Shaanxi Province,China;The Second Hospital of Yulin City,Shaanxi Province,Imaging Center,Yulin 719000,Shaanxi Province,China)

机构地区：[1]陕西省榆林市第二医院磁共振,陕西榆林719000 [2]陕西省榆林市第二医院影像中心,陕西榆林719000

出　　处：《中国CT和MRI杂志》2023年第3期41-43,共3页Chinese Journal of CT and MRI

基　　金：陕西省卫生计生科研基金项目;基于磁共振功能成像技术对脑损伤修复演变过程的研究(2016D098)。

摘　　要：目的探讨磁共振扩散张量(DTI)成像技术在弥漫性轴索损伤(DAI)中的诊断效能,并分析其对预后病情评估的临床价值。方法回顾性选取2017年2月至2020年2月榆林市第二医院收治的DAI患者87例,均符合纳入标准并进行磁共振DTI成像检查,了解神经轴索情况,以手术病理结果为金标准,计算磁共振DTI成像技术在DAI中的诊断效果;随访半年后根据格拉斯哥昏迷量表(GOS)将入组患者分为轻度组(GOS13~15分,n=49例)与中度组(GOS9~12分,n=25例)与重度组(GOS3~8分,n=13例),测量并比较三组大脑半球不同感兴趣区(胼胝体膝部、胼胝体压部、内囊前肢、内囊后肢、外囊)各向异性(FA)值之间的差异,分析其在预后病情评估中的价值。结果87例DAI患者中病理诊断结果显示阳性82例,阴性5例;磁共振DTI成像技术显示阳性80例,阴性4例,其灵敏.度、特异度.、准确率.及阳性和阴.性预测值.分别为9877%、6667%、9655%、9756%、8000%;随访半年后进行检查发现.三组5个感兴趣区FA值比较均存在显著性差异(P<005)。结论磁共振DTI成像技术用于DAI中,能及时发现轴索纤维束破损情况,并确认有无出血病灶;另外还能通过比较感兴趣之间FA值的差异,在病情严重程度及预后评估中发挥重要作用。Objective To investigate the diagnostic efficiency of diffusion tensor imaging(DTI)for diffuse axonal injury(DAI),and analyze its clinical value in condition evaluation.Methods 87 patients with DAI admitted to Yulin Second Hospital between February 2017 and February 2020 were retrospectively selected.All met the inclusion criteria and underwent DTI.Surgical pathological results were taken as the golden standard to calculate the diagnostic efficiency of DTI for DAI.After half a year of followup,patients enrolled were divided into mild group(13-15 points,n=49),moderate group(9-12 points,n=25)and severe group(3-8 points,n=13)according to the Glasgow Outcome Scale(GOS)score.Comparison was made among the 3 groups in terms of fractional anisotropy(FA)values of different regions of interest in cerebral hemisphere(genu of corpus callosum,splenium of corpus callosum,anterior limb of internal capsule,posterior limb of internal capsule and external capsule).The value of DTI in condition evaluation was analyzed.Results Pathological results showed 82 positive cases and 5 negative cases.DTI showed 80 positive cases and 4 negative cases.The sensitivity,specificity,accuracy,positive and negative predictive values of DTI were 98.77%,66.67%,96.55%,97.56%,and 80.00%,respectively.Half a year of follow-up found that FA values of the 5 regions of interest showed statistically significant differences among the 3 groups(P<0.05).Conclusion DTI can detect damage of axonal fiber bundles in time and confirm whether there are bleeding lesions.In addition,FA values of different regions of interest play an important role in condition evaluation of the patients.

关 键 词：磁共振扩散张量成像技术 弥漫性轴索损伤 诊断效能 预后病情评估 

分 类 号：R445.2[医药卫生—影像医学与核医学]