轻度创伤性脑损伤后磁敏感加权成像脑内微出血与外伤后抑郁发生的相关性

Relationship between microbleeds on susceptibility-weighted MRI and newly-developed depression in patients after mild traumatic brain injury

目的:探讨轻度创伤性脑损伤后磁敏感加权成像(SWI)脑内微出血与创伤后新发抑郁症之间的关系。方法:常规CT和MRI检查无明显异常的轻度创伤性脑损伤(TBI)患者行MRI检查,包括常规MR序列和SWI序列。半自动勾勒和手动计数微出血病变的数量和体积。所有患者在TBI后1年内接受DSM-Ⅳ-TR轴Ⅰ障碍临床定式检查(SCID-Ⅳ)。结果:抑郁组SWI微出血病变发生率高于非抑郁组(P<0.001)。在显示出微血管病变的患者中,抑郁组微出血病变数量和体积大于非抑郁组(P<0.001)。这些病变的数量和体积的差异只存在于在额叶、顶叶和颞叶(P<0.001)。在显示出微血管病变的患者中,其他区域的病变数量和体积在抑郁和非抑郁组之间差异无统计学意义。结论:SWI可用于诊断轻度TBI后的微出血病变,病灶的分布范围和位置与TBI后抑郁相关。

Objective：To explore the relationship between abnormality on susceptibility-weighted imaging （SWI）and newly-developed depression after mild traumatic brain injury.Methods：Totally 200 brain injury patients with routine CT and MRI were examined.All patients underwent MRI including conventional MR sequences and SWI.The number and volume of microbleed lesions were semi-automatically outlined and manually counted.All patients were followed up with the Structured Clinical Interview for DSM-Ⅳ Axis I Disorders （SCID-Ⅳ）within 1 year after TBI.Results：The difference in microbleed lesions on SWI was compared between the depressive and non-depressive groups.The depressive group had a higher rate of abnormality on SWI than which in the non-depressive group （P〈0.001 ）.Among patients that had exhibited microbleed lesions,the number and volume of lesions were greater in the depressive group than the non-depressive group （allP〈0.001）. These differences in numbers and volume of lesions were found only at the frontal,parietal,and temporal lobes （all P〈0.001）.Among patients that had exhibited microbleed lesions,the number and volume of lesions in other areas were not significantly different between the depressive and non-depressive groups.Conclusions：SWI was useful to identify the microbleed lesions after mild TBI.The distribution range and location of microbleed lesions were correlated with depression after TBI.