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MRI在诊断弥漫性颅脑轴索损伤中的临床应用价值

作者:李 洲 李建军 邢增宝 王 飞 陈 峰 陈旺生 李长清

所属单位:海南省人民医院放射科(海南 海口 570311)

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摘要

目的研究MRI在诊断弥漫性颅脑 轴索损伤中的临床应用价值,为今后临床 诊断提供参考和借鉴,提高对弥漫性颅脑 轴索损伤的诊断水平。方法 选取2010年 1月-2014年10月期间我院收治的76例弥漫 性颅脑轴索损伤患者为研究对象,根据诊 断方式的不同分为两组,对照组患者采 用CT进行检查,观察组患者采用MRI进行 检查,比较两组患者的诊断结果。结果 观察组对于脑深部区域、非出血病灶及 出血病灶的检出数量明显高于对照组,p <0.05;观察组的诊断敏感度要高于对照 组,p<0.05,差异具有统计学意义。结 论 CT和MRI对弥漫性颅脑轴索损伤的诊断 都具有重要的临床诊断价值,但是MRI的 诊断敏感度要高于CT,尤其是对脑内非出 血病灶和深部病灶的敏感度要高于CT,和 CT检查技术相比,具有更明显的优势,值 得在临床实践中广泛的应用和推广。

Objective To study clinical application value of MRI in the diagnosis of diffuse cerebral axonal injury,and provide a reference for clinical diagnosis in the future,also improve the diagnosis level of diffuse cerebral axonal injury. Methods Seventy six patients with diffuse cerebral axonal injury patients admitted by this hospital from January, 2010 to October, 2014 were selected as research subjects, who were divided into two groups according to different methods of diagnosis, patients in the control group were subject to CT examination, and patients in the observation group were subject to examinations with magnetic resonance imaging (MRI), diagnosis results of patients in two groups were compared. Results The detection quantity of deep cerebra area, non-bleeding lesions and bleeding lesions of patients in the observation group were significantly higher than that of patients in the control group, p<0.05, and the diagnosis sensitivity of patients in the observation group was higher than that of patients in the control group, p<0.05, and the difference was statistically significant. Conclusions Both CT and MRI pose important clinical diagnostic value in the diagnosis of diffuse cerebral axonal injury, but the diagnosis sensitivity of MRI is higher than that of CT, especially the sensitivity of non-bleeding cerebral lesions and deep lesions is higher that of CT, and it delivers more significant advantages when compared to CT examination technology, being worthy of wide application and promotion in clinical practices.

【关键词】核磁共振成像;弥漫性颅脑轴索损伤;计算机断层扫描;诊断

【中图分类号】R651.15; R445.2

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2015.05.003

前言

弥漫性颅脑轴索损伤(Diffuse axonal injury,DAI)又被称为是 脑白质剪切损伤,是指大脑灰白质在外力旋转作用下,引起脑灰白质 交界处及中位线结构的撕裂,属于重型颅脑损伤中比较常见的一种, 同时也是原发性颅脑损伤中的一种[1]。弥漫性颅脑轴索损伤是一种较 为严重的脑外伤,其临床表现主要为患者有广泛的脑肿胀,脑内轴 索水肿等。大多数患者在受伤之后,会长时间昏迷,而且死亡率非常 的高,即使在治疗之后其预后也比较差,可以导致患者残疾、或者植 物生存[2]。而目前临床上对于弥漫性颅脑轴索损伤的诊断主要有CT检 查、MRI检查及其他的影像学检查手段,而弥漫性颅脑轴索损伤的特点 主要是非出血性病灶和一些比较小的出血。有数据显示[3],MRI在对其 的诊断能力要显著高于CT。因此,我院根据76例弥漫性颅脑轴索损伤 患者的临床资料进行回顾性分析和总结,探讨MRI诊断弥漫性颅脑轴索 损伤的价值,为今后临床诊断提供依据,现将结果报告如下。