磁敏感加权成像对轻型颅脑损伤的临床应用价值

Clinical value of magnetic susceptibility-weighted imaging in the application of mild traumatic brain injury

目的 探讨磁敏感加权成像（SWI）对轻型颅脑损伤的诊断价值。方法 回顾性分析78例轻型颅脑外伤患者的临床资料，患者均行MRI常规序列（T1WI、T2WI和FLAIR）及SWI检查，比较SWI与MRI常规序列检出的出血灶数量。结果 SWI检出出血灶率明显高于MRI常规序列[39.74%（31/78）比21.79%（17/78）]，差异有统计学意义（χ2= 5.898，P= 0.015）。SWI检出出血灶156个，T1WI、T2WI和FLAIR检出病灶数量分别为16、26和37个，SWI检出出血灶数量明显高于MRI常规序列，差异有统计学意义（Z=- 4.563、- 4.476和- 4.478，P〈0.01）。SWI检出出血灶患者入院时格拉斯哥昏迷评分明显低于未检出出血灶患者[（14.23 ± 0.80）分比（14.84 ± 0.48）分]，差异有统计学意义（Z=- 3.956，P〈0.01）；SWI检出出血灶数量与患者入院时格拉斯哥昏迷评分呈负相关（rs=- 0.471，P= 0.008）。结论 SWI对轻型颅脑损伤患者出血灶的检出情况明显优于MRI常规序列，能更加客观、准确地评估轻型颅脑损伤患者的病情程度。

Objective To investigate the diagnostic value of susceptibility-weighted imaging （SWI） in the application of mild traumatic brain injury. Methods The clinical data of 78 patients with mild traumatic brain injury were analyzed retrospectively. All patients received SWI and conventional MRI examination （T1WI, T2WI and FLAIR）, and the number of intracerebral hemorrhagic lesions was compared between SWI and conventional MRI.Results The number of intracerebral hemorrhagic lesions of SWI examination was significantly much than that of conventional MRI examination： 39.74% （31/78） vs. 21.79% （17/78）, and there was statistical difference （χ2= 5.898, P= 0.015）. SWI depicted 156 hemorrhagic lesions, and conventional MRI （T1WI, T2WI and FLAIR） depicted 16, 26 and 37 hemorrhagic lesions. SWI depicted a significantly higher number of hemorrhagic lesions than conventional MRI, and there was statistical difference （Z=- 4.563,- 4.476 and- 4.478; P〈0.01）. The Glasgow coma score on admission in patients with hemorrhagic lesions of SWI examination was significantly lower than that in patients without hemorrhagic lesions of SWI examination： （14.23 ± 0.80） scores vs. （14.84 ± 0.48） scores,and there was statistical difference （Z=- 3.956, P〈0.01）. The number of intracerebral hemorrhagic lesions in SWI examination was negative correlation with Glasgow coma score on admission （rs=- 0.471, P= 0.008）.Conclusions SWI has higher sensitivity in detecting intracerebral hemorrhages compared with conventional MRI. It can objectively and accurately evaluate the severity of patients with mild traumatic brain injury.