目的探讨弥漫性轴索损伤 (DAI)患者颅脑CT表现与病情严重程度及 预后的关系。方法 回顾性收集2017年2 月-2018年2月我院神经外科收治的104例 DAI患者，根据颅脑CT表现分为单纯脚间 池出血组(n=37例)、单纯中线区出血组 (n=19例)、脚间池出血合并单纯中线区 出血组(n=19例)及对照组(n=29例)；比 较各组入院时格拉斯哥昏迷指数(GCS) 评分、昏迷时间、脑干受损率及预后不 良率，并采用Spearman相关系数分析脚 间池出血与脑干受损的相关性分析。结 果 与对照组比较，单纯脚间池出血组、 单纯中线区出血组或脚间池、中线区出 血组GCS评分更高，昏迷时间更长、脑干 受损比例更大，预后不良率更高，差异 均有统计学意义(P<0.05)。与单纯中线 区组比较，单纯脚间池出血组GCS评分 更高，昏迷时间更长、脑干受损比例更 大，预后不良率更高，差异均有统计学 意义(P<0.05)。Spearman相关性分析显 示，脚间池出血与脑干受损呈明显正相关 (r=0.768,P<0.05)。结论 DAI患者颅脑CT 的脚间池出血、中线区出血征象可反映预 后不良，尤其是脚间池出血与脑干损伤有 着明显相关性。

Objective To investigate the relationship between CT findings of diffuse axonal injury (DAI) and the severity and prognosis. Methods A total of 104 patients with DAI who were admitted to the department of neurosurgery of the hospital from February 2017 to February 2018 were divided into the simple interpeduncular cistern hemorrhage group (n=37), the simple midline hemorrhage group (n=19), interpeduncular cistern hemorrhage with midline hemorrhage group (n=19) and control group (n=29). The Glasgow Coma Scale (GCS) score, coma time, brainstem damage rate and poor prognosis rate were compared between groups. The correlation between interpeduncular cistern hemorrhage and brainstem damage was analyzed by Spearman correlation coefficient analysis. Results Compared with the control group, the GCS score was higher, coma time was longer, the proportion of brainstem damage was larger and the poor prognosis rate was higher in the simple interpeduncular cistern hemorrhage, the midline hemorrhage group or interpeduncular cistern hemorrhage with midline hemorrhage group (P<0.05). Compared with the simple midline hemorrhage group, the GCS score was higher, coma time was longer, the proportion of brainstem damage was larger and the poor prognosis rate was higher in the simple interpeduncular cistern hemorrhage (P<0.05). Spearman correlation analysis showed that there was a significant positive correlation between interpeduncular cistern hemorrhage and brainstem damage (r=0.768, P<0.05). Conclusion CT signs of interpeduncular cistern hemorrhage and midline hemorrhage of patients with DAI can reflect the poor prognosis. There is an obvious correlation between interpeduncular cistern hemorrhage and brainstem damage.