上海交通大学学报（医学版）

›› 2013, Vol. 33 ›› Issue (4): 454-.doi: 10.3969/j.issn.1674-8115.2013.04.015

• 论著（临床研究） • 上一篇    下一篇

3.0T磁共振成像在重型颅脑外伤诊断及预后评估中的价值

袁陆涛1, 魏小二2, 徐 晨1, 田恒力1, 郭 衍1, 高文伟1, 王 敢1, 陈世文1   

  1. 上海交通大学附属第六人民医院 1.神经外科, 2.放射科, 上海 200233
  • 出版日期:2013-04-28 发布日期:2013-05-03
  • 作者简介:袁陆涛（1987—）, 男, 住院医师, 硕士； 电子信箱: yuansu00@126.com。
  • 基金资助:

    上海市博士后基金（07R214136）

Value of 3.0T magnetic resonance imaging in diagnosis of severe traumatic brain injury and outcome prediction

YUAN Lu-tao1, WEI Xiao-er2, XU Chen1, TIAN Heng-li1, GUO Yan1, GAO Wen-wei1, WANG Gan1, CHEN Shi-wen1   

  1. 1.Department of Neurosurgery, 2.Department of Radiology, the Sixth People´s Hospital, Shanghai Jiaotong University, Shanghai 200233, China
  • Online:2013-04-28 Published:2013-05-03
  • Supported by:

    Shanghai Postdoctoral Science Foundation, 07R214136

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摘要：

目的 评价3.0T磁共振成像（MRI）对重型脑外伤诊断及预后的价值。方法 对38例重型脑外伤患者在伤后4～6周行3.0T MRI检查，定量计算在T1、T2及液体衰减反转恢复（FLAIR）加权相的伤灶体积，与同时期螺旋CT比较；记录弥漫性轴索损伤（DAI）评分，与患者入院时格拉斯哥昏迷评分（GCS）及伤后6个月格拉斯哥预后评分（GOS）进行相关性分析。结果 与CT相比，MRI可显示更多的伤灶，且对胼胝体及脑干损伤更敏感。不同预后组间T1、T2及FLAIR序列所显示的伤灶体积及DAI评分比较,差异有统计学意义（P<0.05)。DAI评分与伤后6个月GOS相关性最强（r=－0.854, P<0.05）；MRI所显示的伤灶体积与预后呈负相关（P<0.05)。结论 3.0T MRI对脑实质损伤的显示明显优于64排螺旋CT，尤其当伤灶位置较深时。定量方法分析MRI所显示的伤灶体积和部位，具有评估预后的价值。

关键词: 重型颅脑外伤, 磁共振成像, 定量检测, 预后

Abstract:

Objective To investigate the value of 3.0T magnetic resonance imaging (MRI) in diagnosis of severe traumatic brain injury and outcome prediction. Methods Thirty-eight patients with severe traumatic brain injury were evaluated with MRI 4 to 6 weeks after injury, the lesion volumes in T1 and T2 weighted imaging and fluid attenuated inversion recovery (FLAIR) images were quantified and compared with simultaneous CT findings. The diffuse axonal injury (DAI) scores were recorded, and correlation analysis was performed with Glasgow coma scale (GCS) on admission and Glasgow outcome scale (GOS) 6 months after injury. Results MRI demonstrated more lesions than CT, especially for the corpus callosum and brain stem lesions. There were significant differences in DAI scores and lesion volumes in T1 and T2 weighted imaging and FLAIR images between different outcome groups (P<0.05). DAI score had strongest correlation with GOS 6 months after injury (r=－0.854, P<0.05), and the lesion volume detected by MRI was also negatively correlated with the outcome （P<0.05). Conclusion 3.0T MRI is superior to CT in detection of intraparenchymal injury, especially for deep lesions. A quantitative study of the lesion volume and location demonstrated by MRI may play a role in outcome prediction.

Key words: severe traumatic brain injury, magnetic resonance imaging, quantitative analysis, outcome