液体衰减反转恢复序列MR成像在颅脑创伤诊断中价值的研究

The Study of diagnostic value of fluid-attenuated inversion-recovery MR imaging for intracranial traumatic lesions

目的 :评价MR液体衰减反转恢复序列 (fluid attenuatedinversionrecovery ,FLAIR)诊断各种颅脑创伤病变的价值。方法 :2 2例颅脑创伤病例均进行了CT和MRT1WI、T2 WI及FLAIR序列检查 ,CT与MR检查的时间间隔为 4.6± 3.7天。观察CT与三种MR序列上各种病变病灶的显示数 ,将FLAIR所见的结果分别与CT、T1WI及T2 WI结果作统计学分析(t检验 )。结果 :2 2例共有 10 0个颅内创伤病灶 ,CT检出率为 2 5 % ,T1WI为 49% ,T2 WI为 71% ,FLAIR检出率为 10 0 % ,差异显著 (P <0 .0 0 0 5 )。其中FLAIR对非出血性脑挫伤的显示效果最佳 ,优于其它三种技术 (P <0 .0 0 0 5 ) ;对于出血性挫伤 ,FLAIR优于CT(P <0 .0 0 2 5 ) ,但与T1WI及T2 WI无明显差别 ;FLAIR对硬膜下 /硬膜外血肿的发现能力与其它三种技术相似 ,对硬膜下积液的显示优于CT(P <0 .0 0 2 5 ) ,与T1WI及T2 WI则无显著差异 ;FLAIR对亚急性期的蛛网膜下腔出血(SAH)的显示能力超过CT和T2 WI(P <0 .0 5 ) ,但CT与FLAIR对急性SAH的显示能力一致。结论 :FLAIR序列能明显地改善颅脑创伤性病变的显示 ,优于CT和常规MRI技术 ,其中以非出血性挫伤和亚急性期的SAH效果最佳。

Objective:To probe the diagnostic value of fluid-attenuated inversion-recovery(FLAIR) MR imaging in intracranial traumatic lesions.Methods:Twenty-two patients with head injury underwent CT and MRI scan.SE T 1WI,T 2WI and FLAIR scan were made to all cases.The interval between CT and MRI examination was 4.6±3.7days.We recorded the number of traumatic lesions showed on the four imaging tecniques.Relationship of leions detection between FLAIR sequence and other three techniques was assessed with test.Results:100 traumatic lesions were detected to these 22 cases.The detection rates are:CT 25%,T 1WI 49%,T 2WI 71%,FIAIR 100%(P<0.0005).Non-hemorrhagic contussion of brain was showed best on FLAIR imaging(P<0.0005).Hemorrhagic contusion of brain was detected better with FLAIR technique than with CT(P<0.0025),but there is no difference between FLAIR and the other two sequences in detecting.The detection rate of subdural or extradural hematomas with is similar to that of the other three techniques.In detecting subdural fluid accumulation,FLAIR sequence is only better than CT.Among subarachnoid hemorrhage(SAH),only the subacute type was showed better on FLAIR than on CT and T 2WI.Conclusion:Detection ability of imaging techniques for intracranial traumatic lesions was improved greatly with FLAIR sequence,especially to non-hemorrhagic contussion of brain and subacute SAH.FLAIR sequence should be applied routinely in medical imaging of head injury cases.