MRI常规序列、DWI及SWI在脑外伤DAI病灶及微出血病灶诊断中的应用价值

Application value of conventional MRI sequence,DWI and SWI in the diagnosis of cerebral DAI and trauma microbleeds lesions

目的探究MRI常规序列、弥散加权成像(DWI)及磁敏感加权成像(SWI)对脑外伤所致弥漫性轴索损伤(DAI)病灶及其微出血病灶的诊断价值。方法选择因脑外伤导致DAI合并微出血的57例患者作为研究对象,所有患者均在入院后即可完成MRI常规序列、DWI、SWI等序列扫描检查。分析各序列检查DAI病灶的信号特征及分布情况,对比各序列对不同分布区域DAI病灶以及微出血病灶、水肿性病灶的检出情况。结果DAI病灶主要分布在基底节、胼胝体、丘脑、深部白质区、脑干和皮髓质交界区。SWI、DWI的DAI病灶总检出率均明显高于T1WI、T2WI,差异有统计学意义(χ^(2)分别=357.06、174.96、236.47、84.30,P均<0.05)。SWI对微出血病灶的检出数目明显多于DWI、T1WI和T2WI(χ^(2)分别=345.21、307.75、234.92,P均<0.05),DWI对水肿性病灶的检出数目明显多于SWI、T1WI和T2WI(χ^(2)分别=159.04、45.83、145.46,P均<0.05)。结论DWI序列和SWI序列与常规MRI序列相比,能够明显提升DAI病灶的检出率。SWI序列在检出微出血病灶上的敏感性优于DWI序列,DWI序列则在检出单纯水肿性病灶方面更具优势。

Objective To research the diagnostic value of conventional MRI sequence,diffusion-weighted imaging(DWI)and susceptibility weighted imaging(SWI)in diffuse axonal injury(DAI)and microbleeds lesions caused by brain injury.Methods Totally 57 patients with DAI complicated with microbleeds due to brain trauma were selected as the research objects.All patients were able to complete MRI conventional sequence,DWI,SWI sequence scanning after admission.The signal characteristics and distribution of DAI lesions were analyzed,and the detection of DAI lesions in different distribution areas,microbleeds lesions,and edema lesions were compared.Results DAI lesions were mainly distributed in basal ganglia,corpus callosum,thalamus,deep white matter area,brain stem and corticomedullary junction area.The detection rate of DAI by SWI and DWI was significantly hihger than that by T1WI and T2WI(χ^(2)=357.06,174.96,236.47,84.30,P<0.05).The number of microbleeds lesions detected by SWI was significantly more than by of DWI,T1WI,and T2WI,and the number of edema lesions detected by DWI was significantly more than by of SWI,T1WI,and T2WI,the differences were statistically significant(χ^(2)=345.21,307.75,234.92,159.04,45.83,145.46,P<0.05).Concl⁃usion Compared with conventional MRI sequence,DWI sequence and SWI sequence can significantly improve the detection rate of DAI lesions.SWI sequence is more sensitive than DWI sequence in detecting microbleeds lesions,while DWI sequence has more advantages in detecting simple edema lesions.