CT和MRI在脑弥漫性轴索损伤诊断中的价值比较

Comparative study on values of CT and MRI for diagnosis of diffuse axonal injury

目的:探讨CT和MRI技术在脑弥漫性轴索损伤诊断中的应用价值。方法:回顾性分析2012年11月至2014年12月收治的52例脑弥漫性轴索损伤患者资料,所有患者均行CT和MRI检查,比较CT和MRI技术发现各个部位病灶的能力以及诊断的敏感度。结果:CT诊断敏感度(48.08%)明显低于MRI(73.08%)(P<0.05)。25例CT检查表现异常者中共发现病灶56个;38例MRI检查表现异常者中T_1WI序列发现病灶99个,T_2WI序列发现病灶137个,FLAIR序列发现异常171个,MRI各序列发现病灶数明显高于CT(P<0.05)。影像学征象表现为弥漫性脑肿胀、蛛网膜下腔及脑室出血、硬膜外血肿和脑实质出血或水肿。结论:CT和MRI技术为脑弥漫性轴索损伤的诊断和治疗提供了可靠依据,MRI技术对脑弥漫性轴索损伤诊断的敏感度明显优于CT技术,值得临床推广使用。

Objective To explore the application values of CT and MRI in the diagnosis of diffuse axonal injury. Methods Totally 52 cases of diffuse axonal injury patients from November 2012 to December 2014 were retrospectively analyzed, who underwent examinations by CT and MRI, then the abilities to find the lesions and the sensitivities of CT and MRI were compared. Results The diagnosis sensitivity of CT（48.08%） was significantly lower than that of MRI（73.08%）（P〈0.05）. There were 56 lesions of 25 abnormal cases detected by CT, and there were 99 lesions in the T1WI sequence, 137 lesions in T_2WI sequence, 171 lesions in the FLAIR sequence of 38 abnormal cases detected by MRI. The numbers of lesions found by MRI were significantly higher than those by CT（P〈0.05）. The radiographic signs showed as diffuse brain swelling, subarachnoid and ventricular hemorrhage, epidural hematoma and parenchymal hemorrhage or edema. Conclusion CT and MRI contribute to the diagnosis and treatment of diffuse axonal injury. MRI gains advantages over CT in the sensitivity of diagnosing diffuse axonal injury, and thus is worthy promoting clinically.