核磁共振磁敏感加权成像技术诊断脑震荡的应用价值

目的探讨核磁共振磁敏感加权成像技术在脑震荡诊断中的应用价值.方法收集2013年12月至2014年12月在兰溪市人民医院以"头部轻微伤"就诊考虑为脑震荡的患者120例,随机选取30例患者作为观察组,另同期从全市召集健康志愿者15例作为对照组.两组分别应用MRI与核磁共振磁敏感成像技术(SWI)进行颅脑检查,比较MRI与SWI成像诊断脑震荡疾病的阳性检出率及两组受试对象的SWI校正相位值,观察患者病灶的出血情况和脑震荡后综合征(PCS)发生情况.结果SWI成像的阳性检出率为46.7%,发现出血灶74个;传统MRI成像的阳性检出率为16.7%,发现出血灶43个;健康对照组15例志愿者常规MRI及SWI检查均未发现细小出血灶;SWI相比于颅脑MRI及CT,其敏感性更好,病灶检出阳性率更高,差异有统计学意义(P<0.05).观察组病灶区SWI校正相位值(82.77±15.36)低于对照组正常对照区SWI校正相位值(473.93±32.33),差异有统计学意义(P<0.05).6个月随访,SWI(+)患者发生PCS 10例(10/14),SWI(-)患者发生PCS 4例(4/16),差异有统计学意义(P<0.05),脑内出血灶与PCS具有相关性.结论核磁共振磁敏感加权成像技术能提高脑震荡患者病灶的检出率,可帮助进一步完善脑震荡的临床诊断标准,并指导临床治疗及判断病情预后.

Objective To explore the application value of MRI susceptibility weighted imaging technology in the diagnosis of concussion.Methods A collection of 120 patients considered for concussion with"minor head injuries"in Lanxi People's Hospital from December 2013 to December 2014,30 patients were randomly selected as the observation group,and healthy volunteers from the whole city were convened during the same period 15 cases served as a control group.The two groups were respectively used MRI and magnetic resonance magnetic susceptibility imaging(SWI)for cranial examination,and the positive detection rate of MRI and SWI imaging in the diagnosis of concussion disease and the SWI correction phase value of the two groups of subjects were compared.The lesions of the patients bleeding and post-concussion syndrome(PCS)occurrence were observed.Results The positive detection rate of SWI imaging was 46.7%,and 74 bleeding foci were found;the positive detection rate of traditional MRI imaging was 16.7%,43 bleeding foci were found;15 volunteers in the healthy control group were not found by conventional MRI and SWI small hemorrhagic foci:Compared with cranial MRI and CT,SWI had better sensitivity and a higher positive rate oflesion detection.The difference is statistically significant(P<0.05).The SWI corrected phase value of the lesion area in the observation group(82.77±15.36)was lower than the SWI corrected phase value of the normal control area(473.93±32.33)in the control group,and the difference was statistically significant(P<0.05).Follow-up for 6 months,SWI(+)patients developed PCS in 10 cases(10/14),SWI(-)patients developed PCS in 4 cases(4/16),the difference was statistically significant(P<0.05),intracerebral hemorrhage lesions were similar to PCS is relevant.Conclusion Magnetic resonance susceptibility weighted imaging technology can improve the detection rate of concussion patients'lesions,can help further improve the clinical diagnostic criteria of concussion,and guide clinical treatment and judge the prognosis of the disease.