脑弥漫性轴索损伤的MRI表现

MRI manifestations in patients with diffuse axonal injury

目的 分析脑弥漫性轴索损伤 (DAI)的MRI表现 ,评价MRI对脑弥漫性轴索损伤的诊断价值。 方法 回顾性分析 30例CT检查阴性的脑弥漫性轴索损伤的MRI表现。MRI分别采用自旋回波T1WI、T2WI序列、液体衰减反转恢复序列 (FLAIR)及弥散加权成像 (DWI)。所有扫描在伤后 1周内进行。 结果 轴索积聚区多发的小灶性损伤 ,多数病灶为非出血性 (<2cm) ,除 3例超急性期外 ,所有病灶T2WI均显示为高信号 ,中线结构无明显移位。在超急性期患者 ,仅DWI上显示出高信号病灶。 结论 MRI对脑弥漫性轴索损伤敏感性较高 ,其影像学表现与DAI的严重程度有较好的对应关系。采用MRI检查CT表现阴性的临床疑诊患者 。

Objective To analyze MRI features of diffuse axonal injury (DAI) and assess the value of MRI in the diagnosis of DAI. Methods A retrospective study of MRI manifestations was performed in 30 cases of DAI with normal CT findings. The MRI scannings were done respectively by using spin echo T1W1 and T2W1, fluid attenuated inversion recovery (FLAIR) and diffusion weighted imaging (DWI) within one week after injury. Results MRI showed that most of multiple lesions in brain axonal region were small and non hemorrhagic (<2 cm). There was no obvious displacement of the median lines. All the cases had hyperintense signal in T2WI except for three cases being at the superacute phase with insignificant middle line displacement.The hyperintense signal of the foci could be shown only in DWI. Conclusions MRI maintains high sensitivity to DAI. The MRI manifestations have sound correspondence with the severity of DAI. MRI plays an important role in diagnosis and treatment of DAI in patients with normal CT.