三维磁敏感成像联合三维动脉自旋标记技术对急性期轻度创伤性脑损伤患者的应用价值

Value of 3D SWAN and 3D ASL in patients with acute mild traumatic brain injury

(1)目的探讨三维磁敏感成像(3DSWAN)与三维动脉自旋标记技术(3D ASL)联合应用对急性期轻度创伤性脑损伤(mTBI)患者的应用价值。(2)方法选取符合入选标准及排除标准的54例急性期mTBI患者,于伤后72小时内进行MR常规序列、3DSWAN及3D ASL序列的一站式扫描。(3)结果对于出血性病变,MR常规序列检出23处,3DSWAN检出73处,二者比较差异具有统计学意义(P <0.05);对于非出血性病变,MR常规序列检出43处,3DASL检出92处,包括局部低灌注区81处,局部高灌注区11处,差异具有统计学意义(P <0.05);3DSWAN与3DASL的阳性患者检出率均明显高于MR常规序列,差异具有统计学意义(P <0.05)。(4)结论 3DSWAN及3DASL序列对评估急性期mTBI患者的出血性病变及非出血性病变有重要的应用价值,3DSWAN序列及3DASL序列对水肿病变显示不足,需要MR常规序列的补充。应尽早联合应用三种序列,以全面评估急性期mTBI患者的脑损伤情况,从而为临床早期诊断mTBI及采取相应的治疗措施提供影像学依据。

Objective To explore the value of 3D SWAN and 3D ASL for patients with acute mild traumatic brain injury(mTBI).Methods In 54 cases of acute mTBI patients who met the selection criteria and exclusion criteria,MR routine sequences,3D SWAN and 3D ASL sequence were scanned in the same examination within 72 hours after injury.Results For the hemorrhagic lesions,23 lesions were detected by the routine MR sequences and 73 were detected by 3D SWAN.The difference between the two groups was statistically significant(P<0.05).For the non-hemorrhagic lesions,43 lesions were detected by the routine MR sequences,and 92 were detected by 3D ASL,including 81 local hypoperfusion areas and 11 hyperperfusion areas.The difference was statistically significant(P<0.05).The positive rate of 3D SWAN and 3D ASL was significantly higher than that of MR routine sequence,and the difference was statistically significant(P<0.05).Conclusion The 3D SWAN and 3D ASL sequences are of great value in the evaluation of hemorrhagic and non-hemorrhagic lesions in patients with acute mTBI.3D SWAN sequence and 3D ASL sequence are not enough to show edema lesions,which need supplement of MR routine sequence.In order to evaluate the brain injury in patients with acute mTBI,the mTBI patients should be examined with the MR routine sequence,3D SWAN and 3D ASL sequence as soon as possible after injury,so as to provide the imaging basis for the early diagnosis of mTBI and the corresponding treatment measures.