磁敏感加权成像在轻型颅脑损伤患者中的诊断价值

摘要

Objective To investigate the sensitivity of susceptibility-weighted imaging ( SWI ) for detecting intracranial bleeds ( ICBs ) in patients with mild traumatic brain injury ( MTBI ) , and by comparing to that of conventional computed tomography( CT) and magnetic resonance imaging ( MRI) examine the diagnostic value of SWI in traumatic brain injury patients.Methods CT,MRI,SWI and clinical information of 32 MTBI patients( GCS 13-15) were collected, which were under treatment in our hospital.All patients were under the examination of CT scan, MRI scan and SWI within one week after the injury.Eliminating artifacts of gas, blood vessels and skull base by combining CT and phase diagram,low signals on SWI were demonstrated to be cerebral contusion hemorrhage.The number of lesions and location on the routine MRI sequence and SWI were recorded respectively,and were analyzed in combination with clinical symptoms.Results The sensitivity of SWI in detecting traumatic contusion hemorrhage in patients was significantly higher than the conventional CT and MRI scan, especially in patients with posttraumatic syncope and coma,or with continuous clinical symptoms.Conclusion SWI is more sensitive than conventional CT and MRI scan in detecting tiny contusion and hemorrhagic foci in MTBI patients, may offer valuable objective diagnostic information and has significant meaning to guide the clinical treatment and predict prognosis.%目的 探讨磁共振磁敏感加权成像(SWI)对轻型颅脑损伤(MTBI)患者的诊断价值.方法回顾分析32例MTBI患者(格拉斯哥昏迷量表评分13~15分)的临床资料.患者伤后1周内给予头部CT、MRI及SWI检查,结合CT及相位图排除气体、血管和颅底伪影后,SWI图上的低信号为脑内挫伤出血灶.分别记录MRI常规序列和SWI探查到的病灶数目、发生部位,并结合临床症状进行分析.结果SWI对脑外伤微小挫伤出血灶检查阳性率明显高于CT及MRI普通序列扫描,特别是在伤后出现晕厥昏迷史或持续性出现临床症状的患者中更为明显.结论SWI比常规CT及MRI对MTBI患者脑内微小挫伤及出血灶的检出有更高的准确性和客观的诊断价值,并对指导临床治疗及判断预后有重大意义.