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目的:探讨3.0TMR高分辨磁敏感加权成像(SWI)序列对颅脑弥漫性轴索损伤(DAI)的诊断价值。方法:选择临床诊断为DAI的30例患者行SWI及常规序列扫描,观察患者病灶等,对比SWI与常规MR序列对DAI病灶形态、分布、数目显示的敏感性,并分析与哥拉斯哥昏迷(GCS)评分及预后的相关性。结果:130例DAI患者SWI序列平均病灶个数为22.83个,明显高于T1WI、T2WI、T2flair序列的1.5个、2.13个、4.1个,比较差异有统计学意义(X2=11.44,P<0.05);2SWI序列皮髓质交界区、白质区、基底节、脑干、小脑、胼胝体DAI病灶呈边界清晰、大小不等点状、片状、串珠状、条状、团状不均低信号;3GCS分值越高DAI平均病灶数目越少,两者呈明显负相关(r=-0.715,P<0.05);4痊愈、好转、死亡患者DAI平均病灶数目、脑中线累及率依次增高,比较差异有统计学意义(F=9.29,X2=13.52,P<0.05)。结论:3.0TMR高分辨SWI序列对DTI的敏感性优于常规序列,病灶数目与GCS评分具有相关性,能够较好地预测患者预后情况。
Objective: To investigate the diagnostic value of 3.0TMR high resolution magnetic resonance weighted imaging (SWI) for diffuse axonal injury (DAI) in the brain. Methods: Thirty patients with clinically diagnosed DAI were selected for SWI and routine serial scans, and the lesions of patients were observed. The sensitivity of SWI and conventional MR sequences to the morphology, distribution and number of DAI lesions were compared. The results were compared with those of Glasgow coma (GCS) score and prognosis. Results: The average number of SWI sequences in 130 DAI patients was 22.83, which was significantly higher than that of T1WI, T2WI and T2flair sequences (1.5, 2.13 and 4.1), the difference was statistically significant (X2 = 11.44, P <0.05) The borderline areas of the corticomedullary junction, white matter area, basal ganglia, brainstem, cerebellum and corpus callosum in the 2SWI sequence showed clear boundary, patchy, beaded, The higher the score, the lower the average number of DAI lesions, the two showed a significant negative correlation (r = -0.715, P <0.05); 4 cured, improved, death DAI average number of lesions, midline brain involvement rate increased, the difference was Statistical significance (F = 9.29, X2 = 13.52, P <0.05). CONCLUSION: The sensitivity of 3.0TMR high resolution SWI sequence to DTI is better than that of conventional sequence. The correlation between the number of lesion and GCS score can predict the prognosis of patients.