地震灾害导致弥漫性轴索损伤的MRI诊断
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摘要
目的评价磁共振FLASH序列T2WI对地震灾害导致弥漫性轴索损伤(DAI)的诊断准确性。方法22例地震灾害致DAI患者外伤后均经头部常规SE序列MRIT1WI,T2WI及FLASH序列T2WI检查,所有患者的MRI表现结合文献复习进行分析,并对SE序列与FLASH序列显示DAI病变的能力进行比较。结果所有患者的DAI病变在T1WI上表现为低、稍低、等、稍高信号的斑点状病灶,在T2WI上为高、稍高、等、稍低信号的斑点状病灶,以及在FLASH序列T2WI上为多发斑点状或针尖状低信号病灶。FLASH序列T2WI能显示常规SE序列T1WI和T2WI未发现的更多、更细小的病灶,且更具有特征。结论MRI常规SE序列T1WI,T2WI结合FLASH序列T2WI可对地震灾害导致的外伤性弥漫性轴索损伤作出准确诊断。FLASH序列T2WI在显示DAI的分布范围、大小、数目方面,明显优于常规SE序列T1WI和T2WI。
Objective To assess the diagnostic accuracy of fast low-angle shot (FLASH) sequence T2 weighted imaging(T2WI)for diffuse axonal injury(DAI)caused by earthquake disaster.Methods Twenty-two patients with DAI caused by earthquake disaster underwent the both examinations of conventional SE sequence and FLASH sequence MR imaging of the head after traumatic brain injury.The MRI findings acquired from the both sequences in all patients were analyzed together with review of the literature.The capability of conven-tional SE sequence T1WI,T2WI in visualizing DAI lesions was compared with that of FLASH sequence T2WI.Results The DAI lesions in all patients appeared as mottling foci of low-,slightly low-,iso-,and slightly high signals on T1WI and mottling foci of high-,slightly high-,iso-,and slightly low signals on T2WI,and multiple mottling or needle-tip shape foci of hypointense signals on FLASH sequence T2WI. The latter sequence could visualize more multiple and more small DAI lesions those were invisible on conventional SE sequence T1WI and T2WI.Conclusion The integration of conventional SE sequence and FLASH sequence MR imaging can accurately diagnose DAI caused by earthquake disaster,while FLASH sequence T2WI is significantly superior to conventional SE T1WI and T2WI in visualizing the distribution extent,size and number of DAI lesions.
Objective To assess the diagnostic accuracy of fast low-angle shot (FLASH) sequence T2 weighted imaging(T2WI)for diffuse axonal injury(DAI)caused by earthquake disaster.Methods Twenty-two patients with DAI caused by earthquake disaster underwent the both examinations of conventional SE sequence and FLASH sequence MR imaging of the head after traumatic brain injury.The MRI findings acquired from the both sequences in all patients were analyzed together with review of the literature.The capability of conven-tional SE sequence T1WI,T2WI in visualizing DAI lesions was compared with that of FLASH sequence T2WI.Results The DAI lesions in all patients appeared as mottling foci of low-,slightly low-,iso-,and slightly high signals on T1WI and mottling foci of high-,slightly high-,iso-,and slightly low signals on T2WI,and multiple mottling or needle-tip shape foci of hypointense signals on FLASH sequence T2WI. The latter sequence could visualize more multiple and more small DAI lesions those were invisible on conventional SE sequence T1WI and T2WI.Conclusion The integration of conventional SE sequence and FLASH sequence MR imaging can accurately diagnose DAI caused by earthquake disaster,while FLASH sequence T2WI is significantly superior to conventional SE T1WI and T2WI in visualizing the distribution extent,size and number of DAI lesions.
引文
[1]Giuqni E,Sabatini U,Haqberg GE,et al.Fast detection of diffuse axonal damage in severe traumatic brain injury[J].Am J Neuroradiol,2005,26(5):1140-1148.
[2]周旭峰,张丽雅,张路,等.脑弥漫性轴索损伤的MRI诊断价值及序列优化[J].中国医学影像学杂志,2007,15(6):412-414.
[3]夏平,赵宝忠,郝敬明,等.CT,MR对脑弥漫性轴索损伤的诊断价值[J].影像诊断与介入放射学,2007,16(6):245-248.
[4]徐玉琴,陈建国,郏潜新,等.FLASH及FLAIR序列在脑弥漫性轴索损伤中的诊断价值[J].临床放射学杂志,2007,26(7):657-660.
[5]Besenski N.Traumatic injuries:imaging of head injuries[J].Eur Radiol,2002,12(6):1237-1242.
[6]Vivik S,Zachary D,Haacke EM,et al.Clinical applications of neur-oimaging with susceptibility-weighted imaging[J].Magn Reso Ima-ging,2005,22(3):439-450.
[7]洪国斌,梁碧玲,沈君,等.三维梯度回波磁敏感成像在颅内出血诊断中的初步应用[J].实用放射学杂志,2008,24(2):151-154.
[8]Topal NB,Hakyemez B,Erdoqan C,et al.MR imaging in the detection of diffuse axonal injury with mild traumatic brain injury[J].Neurol Res,2008,30(9):974-978.
[2]周旭峰,张丽雅,张路,等.脑弥漫性轴索损伤的MRI诊断价值及序列优化[J].中国医学影像学杂志,2007,15(6):412-414.
[3]夏平,赵宝忠,郝敬明,等.CT,MR对脑弥漫性轴索损伤的诊断价值[J].影像诊断与介入放射学,2007,16(6):245-248.
[4]徐玉琴,陈建国,郏潜新,等.FLASH及FLAIR序列在脑弥漫性轴索损伤中的诊断价值[J].临床放射学杂志,2007,26(7):657-660.
[5]Besenski N.Traumatic injuries:imaging of head injuries[J].Eur Radiol,2002,12(6):1237-1242.
[6]Vivik S,Zachary D,Haacke EM,et al.Clinical applications of neur-oimaging with susceptibility-weighted imaging[J].Magn Reso Ima-ging,2005,22(3):439-450.
[7]洪国斌,梁碧玲,沈君,等.三维梯度回波磁敏感成像在颅内出血诊断中的初步应用[J].实用放射学杂志,2008,24(2):151-154.
[8]Topal NB,Hakyemez B,Erdoqan C,et al.MR imaging in the detection of diffuse axonal injury with mild traumatic brain injury[J].Neurol Res,2008,30(9):974-978.
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