脑弥漫性轴索损伤的MRI诊断价值(附36例报告)

MRI Diagnosis of Diffuse Encephalic Axonal Injury: An Analysis of 36 Cases

目的 探讨ＭＲＩ对脑弥漫性轴索损伤 (ＤＡＩ)的诊断价值。资料与方法 搜集经临床证实为ＤＡＩ者 98例 ,从中筛选临床及ＭＲＩ资料完整的 36例进行回顾性分析 (其中 1 5例还先后作过ＣＴ检查 )。结果 36例ＤＡＩ早期ＭＲＩ均表现为弥漫性脑肿胀 ,脑室及脑沟、裂、池受压变小或闭塞 ;脑实质出血灶 30例 ,呈斑点状 ,直径大多 <2 .0ｃｍ ,主要位于胼胝体、脑干、小脑、基底节区及皮髓质交界处 ;蛛网膜下腔和 /或脑室出血 2 4例 ;合并硬膜外血肿9例 ,硬膜下血肿 1 2例 ,颅骨骨折 5例。结论 ＭＲＩ对ＤＡＩ具有较高的诊断价值 ,可弥补ＣＴ的局限性 。

Objective To evaluate MRI in the diagnosis of diffuse encephalic axonal injury (DAI).Materials and Methods Ninety eight patients with clinically proved DAI were collected, from which 36 with complete clinical and MRI materials were selected for the study. MRI findings in the 36 cases, together with additional CT findings in 15 of them, were retrospectively analyzed.Results At the early stage of the disease, diffuse encephalic swelling, compressed or occluded ventricles, sulci and cisterna were seen on MRI in all 36 cases. Speckled hemorrhage (<2.0cm) in cerebral parenchyma, mainly located at mesolobus, brain stem, cerebellum, basal nodal region and cortico medullary conjunction, was found in 30 cases. Hemorrhage in subarachnoid cavity and/or ventricle was seen in 24 cases. Epidural hematoma was complicated in 9, subdural hematoma in 12 and skull fracture in 5 cases.Conclusion MRI is of great value for the diagnosis of DAI. It can be considered as a supplement to CT scans and can provide useful information for early diagnosis and for the evaluation of the treatment and prognosis.