脑弥漫性轴索损伤的影像诊断价值

The value of imaging in diagnosis of diffuse axonal brain injury

目的探讨CT、MR对脑弥漫轴索损伤(DAI)的诊断价值及与临床、预后关系。方法回顾性分析经临床确诊的DAI 32例,患者均做了CT检查,其中22行CT及MR检查。结果32例中共发现237个病灶,其中胼胝体12个,脑干3个,基底节区8个,大脑白质211个,小脑半球3个。85.2%病灶为非出血性病灶,T1W低信号,T2W高信号。损伤部位与患者临床预后、GCS评分有统计学差异(P<0.05)。结论MR为DAI的临床诊断、预后判断提供了可靠的影像学依据。

Objective To assess the value of MRI and CT in diagnosis of diffuse axonal injury（DAI）by analyzing manifestations on their images. Mechods 32 cases with clinically-proved DAI were analyzed retrospectively. All these patients had undergone CT,and 22 patients undergone CT and MRI. Results 237 lesions were recognized. The lesions were located in corpus in 12 cases,brain stem in 3 cases,basal nodal region in 8 cases,cerebral white matter in 211 cases,and cerebella in 3 cases. In the study, 85.20% of DAI were non-hemorrhagic. There was statistic significance between lesion location and prognosis and score on GCS（P〈0.05）. Conclusion MRI can provide direct and reliable imaging information for clinical diagnosis and prognosis in DAI.