低场磁共振弥散加权成像对外伤性脑梗死的早期诊断价值

Value analysis of DWI in early diagnosis of post-traumatic cerebral infarction Lixiaomin zhouheping chenping mayaning

目的探讨和分析低场磁共振弥散加权成像(DWI)在早期诊断外伤性脑梗死中的价值。方法对100例重度颅脑损伤患者进行回顾性分析,随机选择同期在我院查体的20例健康人作为对比。结果超早期,CT检查阳性率8.33%(1/12),常规MRI阳性率16.67%(2/12),DWI阳性率91.67%(11/12)。急性期,CT阳性率13.64%(3/22),常规MRI的阳性率59.09%(13/22),DWI阳性率100.00%(22/22)。亚急性期CT检查阳性率40.00%(4/10),常规MRI阳性率70.00%(7/10),DWI阳性率100.00%(10/10)。DWI诊断总准确率97.73%(43/44),常规MRI诊断总准确率50.00%(22/44),CT诊断总准确率18.18%(8/44)。DWI超早期、急性期、亚急性期的诊断准确率和诊断总准确率均高于CT和常规MRI(P<0.05)。预后不良组大脑皮质、内囊后肢和桥脑后部的ADC值均低于对照组和预后良好组(P<0.01)。结论 DWI能在早期诊断出重度颅脑损伤并发脑梗死的患者,在早期评价患者的预后中具有重要作用。

Objective To investigate the value of DWI in early diagnosis of post-traumatic cerebral infarction.Methods During September 201 1 to September 2012,100 cases with post-traumatic cerebral infarction were selected and 20 healthy people were random select-ed as control group.Results Super early：positive rate of CT was 8.33%（1/12）,MRI was 16.67%（2/12）,DWI was 91.67%（11/12）. Acute phase：positive rate of CT was 13.64%（3/22）,conventional MRI was 59.09%（13/22）and DWI was 100.00%（22/22）.Subacute phase：CT was 40.00% （4/10）,conventional MRI was 70.00%（7/10）and DWI was 100.00%（10/10）.Total diagnostic accuracy rate of was DWI 97.73% （43/44）,conventional MRI was 50.00% （22/44）and CT was 18.18%（8/44）.Super early,acute phase,sub-acute phase andtotal diagnostic accuracy rate of DWI were significantly higher than CT and conventional MRI（P〈0.05）.The ADC of cerebral cor-tex,the PLIC and the back of the pon in poor prognosis group were significantly lower than the control group and the good prognosis group（P〈0.01）.Conclusion DWI can diagnose patients with severe brain injury complicated by cerebral infarction in the early stage and have an important role in the early evaluation of the prognosis of patients.