液体衰减反转恢复序列与T_2加权像在弥漫性轴索损伤诊断中的对比研究

The comparison of diagnostic value between FLAIR and T_2WI in diffuse axonal injury

目的探讨磁共振FLAIR技术在弥漫性轴索损伤(diffuseaxonalinjury,DAI)临床诊断中的价值。方法收集2002年10月至2004年3月收治的63例符合本研究纳入标准的颅脑外伤病例,根据DAI诊断标准分成DAI组和非DAI组,比较FLAIR和T2加权像(T2WI)在DAI影像学诊断率和DAI病灶检出率之间的差异,并初步观察FLAIR在发现非典型DAI上的作用。结果FLAIR和T2WI的DAI诊断率分别为87.5%和62.5%,FLAIR显著优于T2WI(P<0.05);T2WI的病灶检出率仅为FLAIR的48.0%,FLAIR显著优于T2WI(P<0.01);同时T2WI和FLAIR在非DAI组各发现1例和6例有典型的DAI损伤征象。结论FLAIR能提高DAI的临床诊断率和病灶检出率,显示损伤范围和程度,且有助于非典型DAI病例的诊断。

Objective To investigate the value of FLAIR in the clinical diagnosis of diffuse axonal injury （ DAI ）. Method 63 patients with craniocerebral injury fit for the standard admitted from October 2002 to April 2004 were divided into DAI group and Non-DAI group according to generally established standard for DAI diagnosis. DAI diagnostic rate and DAI lesion-detecting rate of FLAIR were compared with those of T2WI. The use of FLAIR for the diagnosis of atypical DAI was preliminarily investigated. Result The DAI diagnosis rates of FLAIR and T2WI were 87. 5% and 62. 5% respectively, and the difference between them was statistically significant （ P〈0. 05 ）. The DAI lesion-detecting rate of FLAIR showed significant elevation compared to that of T2WI （P 〈 0. 01 ）, which was only 48. 0% of that of FLAIR. T2WI and FLAIR displayed typical DAI lesions in 1 and 6 patients of Non-DAI group respectively. Conclusion FLAIR can significantly improve DAI diagnostic rate and DAI lesion-detecting rate, and disclose the extent and severity of DAI. FLAIR is also useful for the diagnosis of patients with atvoical manifestations of DAI.