重型颅脑损伤患者颅脑磁共振(MRI)和磁共振波谱(MRS)的临床研究

Clinical research of MRI and MRS on severe traumatic brain injury patients

目的 探讨重型颅脑损伤患者早期行颅脑磁共振（MRI）和磁共振波谱（MRS）检查的可行性和安全性.方法 选择该院已安全行伤后早期的MRI和MRS检查的20例重型颅脑损伤患者,分析检查结果.结果 头颅MRI检查对弥漫性轴突损伤检出率明显高于头颅CT检查（P＜0.05）;不同位置的中脑损伤患者,其预后有显著差异（P＜0.05）;半年后预后评分,GOS4～5分患者的NAA/Cr、NAA/Cho、Cho/Cr比值与l～3分患者的差异显著（P＜0.05）;Barthal评分＞60分患者的NAA/Cr、NAA/Cho、Cho/Cr比值与41 ～60分和≤40分患者的差异显著（P＜0.05）.结论 MRI和MRS诊断能够提高重型颅脑损伤病变的检出率,早期进行MRS检查有利于发现MRI显示与临床症状不符的颅脑损伤.

Abstract：Objective To investigate the feasibility and safety of MRI and MRS on severe traumatic brain injury patients in early period. Methods Twenty cases with severe traumatic brain injury who had safely taken MRI and MRS were selected to analyze. Results Detection rate of diffuse axonal injury of MRI was higher than that of CT（ P 〈 0.05 ） ; the different parts affected showed in iconography had different prognosis （ P 〈 0.05 ） ; NAA/Cr, NAA/Cho, Cho/Cr in patients with GOS 4 - 5 had significant difference with GOS 1 - 3 （P 〈0.05 ） ;NAA/Cr, NAA/Cho, Cho/Cr in patients with Barthal score 〉 60 had significant difference with Barthal score 60 - 41 and ≤40 （P 〈 0.05 ）. Conclusions MRI and MRS diagnosis can improve lesion detection rate of severe traumatic brain injury. Early MRS examination can help to find traumatic brain injury which MRI showed was inconsistent with clinical symptoms.