瓦斯爆炸有毒气体中毒后脑部的动态MRI表现

MRI Dynamic Findings of the Brain in Gas Intoxication

目的动态观察瓦斯爆炸有毒气体中毒后脑部MRI表现及其演变规律。资料与方法对某矿瓦斯爆炸后幸存的49名矿工于1～3d内进行首次脑部MRI检查,并于2个月、6个月及1年进行多次复查,观察脑部病变的影像学改变及其信号演变。结果 1～3dMRI表现:海马(33例)、苍白球(12例)、皮质(10例)、侧脑室周围白质(8例)及中脑(2例)呈稍长T1长T2异常信号。2个月复查:海马异常信号消失25例,遗留稍长T2信号8例,苍白球3例异常信号消失,余9例苍白球病变范围均缩小呈软化灶改变,受累皮质2例演变为软化灶,余病变恢复正常,脑干呈软化灶改变;6个月及1年MRI表现:9例苍白球及2例皮质呈软化灶,9例双侧大脑半球白质内可见云雾状稍长T1稍长T2异常信号影,余脑部其他部位病变均恢复正常。结论 MRI能敏感地检出瓦斯爆炸有毒气体中毒后脑部的异常改变,并能动态观察脑部异常信号的演变,应作为瓦斯爆炸后伤员脑部的首选检查手段。

Purpose To investigate MRI findings and dynamic changes of the brain in gas intoxication. Material and Methods Forty-nine survivals after a gas explosion were examined with brain MRI within 1 to 3 days, and performed serial MR follow-up examinations in the 2nd month, 6th month and 12th month.Results MRI manifestation in 1～3 days, slight long signal on T1 and long signal on T2 were detected on MRI in hippocampus （33 cases）, globus pallidus （12 cases）, cortex （10 cases）, the white matter of periventricle （8 cases） and midbrain （2 cases）.Two months later, the follow-up MRI showed that lesions in hippocampus disappeared （25 cases） or remained slight high signal on T2 （8 cases）, lesions in globus pallidus disappeared （3 cases） or showed shrinkage and malacia （9 cases）, cortical lesions resulted in malacia（2 cases）and returned normal in the others, and lesions in the midbrain showed malacia. On basis of the follow-up MRI in 6 months and 12months, lesions in hippocampus（9 cases） and in cortex （2 cases） showed malacia , slightly long T1 and slightly long T2 abnormal nebulous signal was detected in white matter of double hemispheres （9cases）,the other parts returned normal. Conclusion MRI is sensitive to the lesion of brain caused by gas explosion, and also could observe dynamic changes of abnormal signals. MRI is a prefered investigative means to examine the brain of patients after gas explosion.