MRI在弥散性轴索损伤诊断中的临床应用价值研究

Study on the clinical value of MRI in the diagnosis of diffuse axonal injury

目的分析磁共振成像(MRI)在弥散性轴索损伤(DAI)诊断中的应用价值。方法 64例弥散性轴索损伤患者,根据诊断方法不同分为观察组和对照组,每组32例。观察组患者行MRI扫描诊断,对照组患者行CT扫描诊断。比较两组患者颅内异常(脑室出血、蛛网膜下腔出血、硬膜外血肿、弥散性脑肿胀、脑内出血性病灶、脑内非出血性病灶)检出情况、颅内病灶(大脑皮质下病灶、小脑病灶、基底节病灶、丘脑病灶、胼胝体病灶、中脑病灶、脑干病灶)检出情况以及阳性检出率。结果观察组的脑室出血、蛛网膜下腔出血、硬膜外血肿、弥散性脑肿胀、脑内出血性病灶、脑内非出血性病灶检出率均显著高于对照组,差异具有统计学意义(P<0.05)。观察组的大脑皮质下病灶、小脑病灶检出率分别为81.25%、34.38%,均显著高于对照组的46.88%、12.50%,差异具有统计学意义(P<0.05)。但两组的基底节病灶、丘脑病灶、胼胝体病灶、中脑病灶、脑干病灶检出率比较差异均无统计学意义(P>0.05)。观察组的阳性检出率为96.88%,显著高于对照组的62.50%,差异具有统计学意义(P<0.05)。结论 MRI在弥散性轴索损伤患者诊断中具有较高的准确率,能够有效提高出血及非出血病灶、大脑皮质下病灶的检出率,且其具有较高的诊断敏感性。

Objective To analyze the practical value of magnetic resonance imaging(MRI)in the diagnosis of diffuse axonal injury(DAI).Methods A total of 64 patients with diffuse axonal injury were divided into observation group and control group by different diagnostic methods,with 32 cases in each group.The observation group was diagnosed by MRI scan,and the control group was diagnosed by CT scan.The detection of intracranial abnormalities(intraventricular hemorrhage,subarachnoid hemorrhage,epidural hematoma,diffuse brain swelling,intracerebral hemorrhagic lesions,intracerebral non-hemorrhagic lesions),detection of intracranial lesions(subcortical lesions,cerebellar lesions,basal ganglia lesions,thalamus lesions,corpus callosum lesions,midbrain lesions,brainstem lesions)and positive detection rate were compared between the two groups.Results The detection rate of intraventricular hemorrhage,subarachnoid hemorrhage,epidural hematoma,diffuse brain swelling,intracerebral hemorrhagic lesions,intracerebral non-hemorrhagic lesions of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The detection rate of subcortical lesions and cerebellar lesions of the observation group was 81.25%and 34.38%respectively,which was significantly higher than that of the control group 46.88%and 12.50%,and the difference was statistically significant(P<0.05).There was no statistically significant difference in detection rate of basal ganglia lesions,thalamus lesions,corpus callosum lesions,midbrain lesions,brainstem lesions between the two groups(P>0.05).The positive detection rate of the observation group was 96.88%,which was significantly higher than that of the control group 62.50%,and the difference was statistically significant(P<0.05).Conclusion MRI shows high accuracy for diagnosis of patients with diffuse axonal injury,which can effectively improve the detection rate of bleeding and non-bleeding lesions,and subcortical lesions,and it has high diagnostic sensitivity.