弥漫性轴索损伤CT、MR动态观察

Dynamic observation of CT and MR in cerebral diffuse axonal injury

目的：应用CT、MR成像动态观察脑弥漫性轴索损伤（DAI）脑内病变的演变,阐述DAI不同时期CT、MR表现,为临床提供治疗时间判断、治疗手段选择以及复查时间选择等方面的参考。方法：对29例脑弥漫性轴索损伤的CT、MR表现进行回顾性分析。结果：29例DAI初诊CT表现：27例脑内见出血灶及非出血灶,2例CT正常;3 d内CT或MR复查23例：脑内病灶增多或增大19例,12例出现脑肿胀或继发脑缺血改变,无明显变化4例;3~21 d复查16例：出血灶由高密度变成等密度及等密度变成低密度的平均时间分别7,16 d。21~60 d复查14例：病变区呈现较大范围软化的8例,呈腔隙灶的6例,CT不能发现病灶的6例,合并脑萎缩11例。结论：CT、MR动态观察DAI病灶演变,为DAI的临床诊断和治疗提供可靠依据。

Objective： To use CT and MR imaging to make dynamic observation of the pathological changes of brain evolution in cerebral diffuse axonal injury （DM） , to expound DM in different periods of CT and MR imaging manifestations, for providing references in the judgment of treatment time, selection of treatment methods and selection of check time. Methods： CT and MR findings of 29 cases of diffuse axonal injury were analyzed retrospectively. Results： Of the initial CT manifestations of 29 cases with DAI, 27 cases were found with hemorrhage and non hemorrhage lesion in the brains, 2 cases were normal; within 3 days, 23 cases were checked again by CT or MR, and the results showed that intracerebral lesions increased or enlarged in 19 cases, brains appeared swell- ing and there were ischemic changes in 12 cases, no obvious change in 4 cases; 16 cases were reviewed from 3 to 21 days, the average time for hemorrhage lesion changing from high density to desity, and density to low density were 7 and 16 days. 14 cases were review from 21 to 60 day, lesions of 8 cases showed a wide range of softening, 6 cases were found with lacunar lesions, no lesions was found in 6 cases, and 11 cases were found with cerebral at- rophy. Conclusion： CT and MR can dynamically observe the evolution of DAI lesions, and it will provide refi- able evidence for clinical diagnosis and treatment of DAI