磁共振弥散张量成像在重型外伤性脑损伤手术及预后评估的价值分析

MR diffusion tensor imaging in traumatic brain injury surgery and prognosis evaluation

目的研究外伤性脑损伤手术的磁共振弥散张量成像(DTI)变化情况,以及DTI的改变与患者病情轻重及预后关系,进行预后评估分析。方法收集2018年3月至10月的外伤性脑损伤患者72例,选取38例进行DTI检查。对患者在外伤后的第3个月和第6个月进行复查,研究患者的DTI在恢复期的变化情况。同时与对照组进行比较。对患者的外伤性脑损伤严重程度用哥拉斯哥昏迷评分(GCS)来评价,对患者在6个月时的恢复情况用哥拉斯哥结果评分(GOS)来评价。结果试验组各项异性分数(FA)值与对照组之间差异有统计学意义;重型外伤患者FA值变化情况:随着外伤后时间的延长,FA值逐渐升高,虽然6个月时各部位的FA值仍低于健康对照组,但是差异无统计学意义;患者急性期FA值的GCS评分及GOS评分具有相关性。结论DTI检查可作为评估外伤性脑损伤患者病情严重性及预后情况的有力工具,对外伤性脑损伤手术的预后评估具有积极意义。

Objective To study the changes of diffusion tensor imaging(DTI)in traumatic brain injury,and the change of DTI in the patient′s severity and prognosis.Methods Thirty-eight patients with traumatic brain injury were collected from March 2018 to Octorber 2018,and 38 were selected for DTI examination.The patients were reviewed in the third and sixth months after trauma,and the changes of DTI in patients were studied.Compared with the control group.The severity of traumatic brain injury in patients was evaluated with GCS score,which was evaluated by the GOS score for the patient′s recovery at 6 months.Results There was significant difference between the patients′FA value and the control group.Medium and heavy FA value changes in trauma patients:with the extension of time after trauma,the FA value increased,while six months when FA value of each part is still lower than the normal control group,but the difference is not significant;There was a strong correlation between the GCS score and the GOS score of the patients with acute phase FA.Conclusion DTI can be used as a powerful tool for assessing the severity and prognosis of traumatic brain injury patients,and the prognosis of traumatic brain injury surgery is of positive significance.