磁共振弥散张量成像及脑CT灌注成像在重型颅脑损伤患者中的应用  

Application of magnetic resonance diffusion tensor imaging and brain CT perfusion imaging in patients with severe head injury

作　　者：李骏 许建兴[1] 沈烨[1] 何赟 顾勇坚[1] 恽健 LI Jun;XU Jianxing;SHEN Ye;HE Yun;GU Yongjian;YUN Jian(The Affiliated Wujin Hospital of Jiangsu University,Changzhou 213017,China)

机构地区：[1]江苏大学附属武进医院,江苏常州213017

出　　处：《中国实用神经疾病杂志》2023年第12期1512-1516,共5页Chinese Journal of Practical Nervous Diseases

基　　金：2023年度江苏大学医教协同创新基金项目(编号:JDYY2023079);常州市科技计划资助项目(编号:CJ20220166);徐州医科大学附属医院发展基金项目(编号:XYFY2020024)。

摘　　要：目的探究磁共振弥散张量成像及脑CT灌注成像对重型颅脑损伤患者的诊断价值。方法选取2021-03—2022-03江苏大学附属武进医院诊治的颅脑损伤患者180例为研究对象,采用格拉斯哥昏迷量表(GCS)评估患者病情严重程度,将其分为轻度损伤组(102例)、中度损伤组(42例)、重度损伤组(36例)。所有患者均接受磁共振弥散张量成像及脑CT灌注成像检查,比较3组患者磁共振弥散张量成像及脑CT灌注成像参数,即各向异性分数(FA)、脑血流灌注率(CBF),分析磁共振弥散张量成像及脑CT灌注成像对颅脑损伤患者病情的评估价值。结果3组患者FA值、CBF值比较差异均有统计学意义(P<0.05),轻度损伤组FA值、CBF值高于中度损伤组及重度损伤组(P<0.05)。Spearman相关性分析显示,FA、CBF值与颅脑损伤患者病情呈显著负相关,FA、CBF值越小,颅脑损伤越严重(P<0.05)。ROC曲线分析显示,FA值、CBF值及联合评估重度颅脑损伤患者病情程度的曲线AUC分别为0.873、0.804、0.883,均具有一定预测价值。当取最佳cut-off值时,敏感度分别为0.750、0.799、0.840,特异度分别为0.917、0.694、0.833。结论磁共振弥散张量成像联合脑CT灌注成像对重型颅脑损伤患者病情严重程度具有一定评估价值,临床可通过磁共振弥散张量成像、脑CT灌注成像的定量参数分析为颅脑损伤患者病情评估提供参考。Objective To explore the application value of magnetic resonance diffusion tensor imaging and cerebral CT perfusion imaging in patients with severe craniocerebral injury.Methods A total of 180 patients with craniocerebral injury treated in the Affiliated Wujin Hospital of Jiangsu University from March 2021 to March 2022 were selected as research objects.The severity of the patients was assessed by the Glasgow coma scale(GCS),and were divided into the mild injury group(102 cases),the moderate injury group(42 cases),and the severe injury group(36 cases).All patients underwent magnetic resonance diffusion tensor imaging and cerebral CT perfusion imaging.The parameters of MRI diffusion tensor imaging and cerebral CT perfusion imaging,namely,anisotropy fraction(FA)and cerebral blood perfusion rate(CBF),were compared among the three groups to analyze the evaluation value of MRI diffusion tensor imaging and cerebral CT perfusion imaging in patients with cranial brain injury.Results The FA and CBF values of the three groups were statistically significant(P<0.05),the FA and CBF values of the mild injury group were higher than those of the moderate injury group and the severe injury group(P<0.05).Spearman correlation analysis showed that the FA and CBF values were significantly negatively correlated with the condition of patients with craniocerebral injury.The smaller the FA and CBF values were,the more severe the craniocerebral injury was(P<0.05).ROC curve analysis showed that the AUC of FA value,CBF value and combined application to evaluate the condition degree of patients with severe craniocerebral injury was 0.873,0.804 and 0.883,respectively,which had certain predictive value.When the optimal cut-off value is taken,the corresponding sensitivity is 0.750,0.799 and 0.840,respectively.The specificity was 0.917,0.694 and 0.833,respectively.Conclusion Magnetic resonance diffusion tensor imaging combined with cerebral CT perfusion imaging has a certain value in evaluating the severity of severe craniocerebral injury patien

关 键 词：重型颅脑损伤 磁共振弥散张量成像 脑CT灌注成像 Spearman相关性 诊断价值 

分 类 号：R651.15[医药卫生—外科学]