多模态头颅MRI对轻型颅脑损伤的评估价值  

Value of Multimodal Head MRI in Evaluation of Mild Traumatic Brain Injury

作　　者：朱杰[1] 宋彬[1] ZHU Jie;SONG Bin(Department of Radiology,Minhang Hospital,Fudan University,Shanghai 201199,China)

机构地区：[1]上海复旦大学附属闵行医院(上海市闵行区中心医院)放射科,上海201199

出　　处：《中国CT和MRI杂志》2023年第10期14-16,共3页Chinese Journal of CT and MRI

基　　金：上海市闵行区自然科学研究课题(2019MHZ125)。

摘　　要：目的探讨多模态头颅MRI对轻型颅脑损伤(mTBI)患者脑组织损伤性质的早期诊断及其预后评估价值。方法对67例头颅CT平扫阴性的mTBI患者进行多模态头颅MRI检查,根据磁敏感加权成像(SWI)、弥散加权成像(IWI)是否阳性将患者分为SWI阳性组、DWI阳性组、SWI+DWI双阳性组及SWI+DWI双阴性组,并随访外伤3个月后患者颅脑损伤后综合征(PTBS)的发生率。结果SWI阳性患者20例,DWI阳性患者8例,SWI+DWI双阳性患者5例,SWI+DWI双阴性患者34例,三组阳性组患者中PTBS的发生率明显高于双阴性组患者,差异均有统计学意义(P<0.05),三组阳性组间PTBS发生率差异无显著统计学意义(P>0.05)。结论多模态头颅MRI可敏感发现mTBI患者脑内存在的微小出血灶及脑缺血梗死灶等病理改变,为临床诊断及治疗提供影像学依据。Objective To explore the value of multimodal head MRI in early diagnosis and prognosis evaluation of the nature of brain injury in patients with mild traumatic brain injury(mTBI).Methods 67 mTBI patients with negative head CT plain scan were examined by multimodal head MRI.According to whether SWI and DWI were positive,the patients were divided into SWI positive group,DWI positive group,SWI+DWI double positive group,and SWI+DWI double negative group.The incidence of post traumatic brain syndrome(PTBS)in patients 3 months after injury was followed up.Results There were 20 patients with positive SWI,8 patients with positive DWI,5 patients with double positive SWI+DWI,and 34 patients with double negative SWI+DWI.The incidence of PTBS in the three positive groups was significantly higher than that in the double negative group,with statistical significance(P<0.05).There was no significant difference in the incidence of PTBS among the three positive groups(P>0.05).Conclusion Multimodal head MRI can sensitively detect the pathological changes in the brain of patients with mTBI,such as micro hemorrhage and cerebral infarction,providing imaging basis for clinical diagnosis and treatment.

关 键 词：磁共振成像 磁敏感加权成像 弥散加权成像 轻型颅脑损伤 颅脑损伤后综合征 

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]