SWI显示弥漫性轴索损伤病灶个数与GCS评分相关性的分析

Susceptibility-weighted imaging of diffuse axonal injury:a correlative study of lesion-number and Glasgow Score Scale

目的探讨磁敏感加权成像(SWI)显示弥漫性轴索损伤(DAI)的病灶个数与格拉斯哥评分(GCS)的关系及临床意义。方法对30例临床确诊为DAI的脑外伤患者,分别在伤后2h至20d行磁共振(MRI)常规序列(T1WI、T2WI、FLAIR)及SWI序列扫描,并观测患者病灶数量,观察各序列间有无明显差异,并与GCS评分进行相关性分析。结果MRI常规序列扫描发现124个病灶;SWI序列发现621个病灶,SWI序列发现病灶数量明显多于常规磁共振扫描(u=-10.235,P<0.01),其中SWI序列显示的病灶数量与GCS评分之间呈明显的负相关(r=-0.867,P<0.01)。结论SWI序列可以在DAI患者中发现更多的出血病灶,并且病灶的数量与GCS评分密切相关,对DAI的诊断及判断患者的预后有很高的价值。

Objective To study the relationship between lesion-number of diffuse axonal injury（DAI）in susceptibility-weighted imaging（SWI）and Glasgow Score Scale.Methods Thirty patients（21 males and 9 females）with DAI were included in this study.Routine sequences（T1WI,T2WI and FLAIR）and SWI were performed on 3.0 T MRI systems.The injuries were caused by traffic accidents in 22 cases,falls in 5 cases,beatings in 2 case and heavy weight in 1 case.There were 12 cases whose Glasgow Score Scale（GCS）ranged from 3 to 5 and 9 cases from 6 to 8 and 9 from 9 to 12.The time interval between injury and examination was 2 hours to 20 days.The number of lesions in SWI and GCS were analyzed using SPSS 11.5.Results Routine MRI scan found a total of 78 lesions,while SWI sequence detected 424 lesions.The number of lesions found in SWI sequence was higher than that of conventional MRI（u=-10.235,P〈0.01）.The number of lesions were negatively correlated with GCS（r=-0.867,P〈0.01）.Conclusion SWI sequence can find more bleeding lesions than routine MRI sequence.The number of lesions was closely related to GCS.SWI shows a high value in diagnosis and prognosis of DAI.