脑弥漫性轴索损伤的MRI表现与GCS计分及预后的关系

The Relationships Between MRI Findings in Diffuse Axonal Injury and Its GCS,Clinical Prognosis

目的研究脑弥漫性轴索损伤(DAI)的MRI征象,探讨MRI对DAI的诊断价值。方法回顾性分析40例DAI患者的临床资料和MRI征象,按病灶累及部位分组,分析病灶累及部位与临床的预后、GCS计分的关系。结果40例DAI患者中共发现63个病灶,大脑白质34个,基底节区5个,胼胝体9个,小脑4个,桥脑5个,大脑脚3个,延髓3个。19例病例病灶累及脑中线部位,21例未累及脑中线部位。治愈15例,好转19例,植物状态3例,死亡3例。GCS计分13～15分2例,9～12分8例,≤8分30例。结论病灶累及脑中线部位,预后差且GCS计分较低。综合分析DAI的临床资料和MRI征象,MRI是诊断DAI重要的检查方法,可在一定程度上为临床的早期诊断、治疗、治疗监测及评估预后提供依据。

Objective:To study the findings of diffuse axonal injury (DAI) on MRI and evaluate their value.Methods:A retrospective study was conducted on 40 patients with DAI on the MRI and the clinic features,the relationships between location and clinical prognosis,GCS marking were evaluated.Results:Totally 63 lesions were found in 40 cases,including 34 lesions in cerebral white matter,5 lesions in basal ganglia,9 lesions in corpus callosum,4 lesions in cerebellum,5 lesions in pons,3 lesions in cerebral peduncle,3 lesions in medulla oblongata.The lesions involved the medial part of brain in 19 cases,The lesions did not involved the medial part of brain in 21 cases.15 cases had been cured,19 cases straightened up,3 cases showed a state of plant, 3 cases died.There were 2 cases got 13～15 GCS points,8 cases got 9～12 GCS points,and 30 cases got lower than 8 points.Conclusion:The lesions involving the medial part of brain had worse prognosis and got lower GCS than leisions that no involving the medial part of brain.Analyzing comprehensively the MRI and the Clinic features in diffuse axonal injury,MRI is one of the important examining methods for DAI,to a certain extent,can provide evidences for early diagnosis,therapy,supervision and prognosis.