3.0MR高分辨磁敏感加权成像对颅脑弥漫性轴索损伤的诊断价值

Diagnostic Value of 3.0MR High Resolution Magnetic Susceptibility Weighted Imaging for Cerebral Diffuse Axonal Injury

目的:探讨3.0TMR高分辨磁敏感加权成像(SWI)序列对颅脑弥漫性轴索损伤(DAI)的诊断价值。方法:选择临床诊断为DAI的30例患者行SWI及常规序列扫描,观察患者病灶等,对比SWI与常规MR序列对DAI病灶形态、分布、数目显示的敏感性,并分析与哥拉斯哥昏迷(GCS)评分及预后的相关性。结果:130例DAI患者SWI序列平均病灶个数为22.83个,明显高于T1WI、T2WI、T2flair序列的1.5个、2.13个、4.1个,比较差异有统计学意义(X2=11.44,P<0.05);2SWI序列皮髓质交界区、白质区、基底节、脑干、小脑、胼胝体DAI病灶呈边界清晰、大小不等点状、片状、串珠状、条状、团状不均低信号;3GCS分值越高DAI平均病灶数目越少,两者呈明显负相关(r=-0.715,P<0.05);4痊愈、好转、死亡患者DAI平均病灶数目、脑中线累及率依次增高,比较差异有统计学意义(F=9.29,X2=13.52,P<0.05)。结论:3.0TMR高分辨SWI序列对DTI的敏感性优于常规序列,病灶数目与GCS评分具有相关性,能够较好地预测患者预后情况。

Objective： To investigate the diagnostic value of 3.0MR high resolution magnetic susceptibility weighted imaging（SWI） for cerebral diffuse axonal injury（DAI）. Methods： 30 cases of patients who were diagnosed with DAI underwent SWI and conventional sequence scan, the sensitivity and lesion morphology, distribution and lesion number of DAI tested by SWI and conventional sequence scan were compared, and its correlation with Glasgow Coma Score（GCS） and the prognosis were analyzed.Results： 1lesion number tested by SWI sequence in 30 cases of patients with DAI was 22.83, significantly higher than those（1.5, 2.13,4.1 respectively） of T1 WI, T2 WI, T2 flair sequence, the difference was statistically significant（ X2=11.44, P 0.05）; 2 The SWI sequence presented that corticomedullary junction zone, white matter regions, basal ganglia, brain stem, cerebellum, corpus callosum DAI lesions showed clear boundaries, different size dot, sheet, strip, beaded, dough nonuniform low signal; 3 The average number of lesions was smaller when the GCS value was higher, there was a significant negative correlation between them（r=-0.715, P〈0.05）;4The DAI average number of DAI lesions, midline involving rate increased in cases of recovery, improvement, death, the difference was statistically significant（F=9.29, X2=13.52, P〈0.05）. Conclusion： High resolution 3.0 TMR SWI sequences is more sensitive for DTI than conventional sequence, number of lesions is correlated with GCS score, which can predict prognosis of patients.