磁敏感加权成像与CT评价创伤性脑损伤

Susceptibility-weighted imaging and CT in evaluation on traumatic brain injury

目的比较磁敏感加权成像(SWI)与CT评价创伤性脑损伤(TBI)合并出血的作用,探讨其与临床评分的相关性。方法 25例TBI患者均接受16排MSCT和1.5T MR检查,对SWI图像采用SWI最小密度投影(SWI MinIP)观察出血灶,利用SPIN软件测量SWI MinIP及CT图像上出血灶面积及数目,并与患者格拉斯哥昏迷量表(GCS)临床评分结果进行相关性分析,比较不同格拉斯哥预后评分(GOS)组间的差异。结果 TBI患者SWI MinIP图像较相应层面CT图像显示的出血灶面积大(P=0.021),显示的出血灶数目多(P<0.05);且SWI和CT显示出血灶面积、数目均与临床GCS评分呈明显负相关(P均<0.05)。SWI和CT显示预后差的TBI患者出血灶面积及数目均大于预后好者(P均<0.05)。结论与CT相比,SWI检测TBI患者出血灶的敏感度和评价出血灶的面积与数目等方面均具有明显优势,并在评价TBI损伤程度及预后方面与临床评分具有良好相关性。

Objective To compare the effectiveness of susceptibility-weighted imaging（SWI） and CT in the assessment of hemorrhagic traumatic brain injury（TBI）,and to establish the correlation between imaging measurements and clinical scores.Methods Twenty-five TBI patients underwent imaging examination with 16-detector MSCT and 1.5T MR system.The susceptibility weighted imaging minimum intensity projection（SWI MinIP） images were adopted for the visualization of hemorrhagic lesions.The area and number of hemorrhagic lesions were measured by SPIN software.Imaging data of SWI and CT were compared and the correlations with GCS scores were analyzed respectively.Differences between groups of GOS scores were also analyzed.Results Area of hemorrhagic lesions showed on SWI MinIP images was significantly greater than on CT images（P=0.021）,and more hemorrhagic lesions were visible than on CT images（P0.05）.GCS scores was negatively correlated with the hemorrhage area and number on both SWI and CT（all P0.05）.Patients with poor prognosis had greater area and number of hemorrhagic lesions（all P0.05）.Conclusion Compared with CT,SWI is much more sensitive in detecting and assessing hemorrhagic lesions in patients with TBI,which is also useful in evaluating patients＇ prognosis.