磁共振弥漫张量成像对儿童弥漫性轴索损伤程度评估的定量研究

发布时间：2018-03-24 21:27

本文选题：弥漫性轴索损伤　切入点：磁共振成像　出处：《重庆医学》2017年30期

【摘要】：目的比较磁共振弥漫张量成像(DTI)各向异性分数(FA)与入院时格拉斯哥意识障碍量表(GCS)对儿童弥漫性轴索损伤(DAI)患者损伤程度及预后判断的价值。方法 34例DAI患儿入院时采用GCS评分评价意识障碍程度,伤后2周内行DTI检查。健康体检者23例行DTI检查。测量各部位可视性病灶区和健侧对称处FA值及脑中线部位FA值,计算中线部位平均FA值降低程度及可视性病灶平均FA值降低程度。分析GCS评分、可视性病灶平均FA值降低程度及脑中线部位平均FA值与患儿意识障碍时间及伤后半年患儿恢复程度的相关性。结果脑中线部位平均FA值降低程度与患儿意识障碍时间及伤后半年患儿恢复程度呈显著相关(r=0.519,P=0.002;r=0.669,P=0.000);可视性病灶平均FA值降低程度及GCS评分与患儿意识障碍时间及伤后半年患儿恢复程度均呈低度相关或微弱相关(r=0.285,P=0.103;r=0.487,P=0.003;r=-0.241,P=0.169;r=-0.229,P=0.192)。脑中线部位平均FA值降低程度及可视性病灶平均FA值降低程度与伤后半年患儿恢复程度的相关性高于GCS评分。结论 DTI为诊断DAI的敏感方法,较临床普遍采用的GCS评分对DAI患儿的损伤程度及预后判断更有价值。
[Abstract]:Objective to compare the value of anisotropic fraction of diffused Zhang Liang imaging (DTI) and Glasgow Disorder of consciousness scale (Glasgow Disorder of consciousness) at admission in patients with diffuse axonal injury (Dai) in children. Methods 34 children with DAI were treated with DAI. At admission, GCS score was used to evaluate the degree of consciousness disorder. DTI examination was performed within 2 weeks after injury. DTI was performed in 23 healthy persons. FA values in the focus area and normal side were measured, and FA values in the midline of the brain were measured. The reduction degree of mean FA value in midline and the decrease of mean FA value in visible focus were calculated. The GCS score was analyzed. The relationship between the mean FA value of visual lesion and the mean FA value in the midline of the brain and the time of disturbance of consciousness and the recovery degree of the child half a year after injury. Results the decrease of the mean FA value in the middle line of the brain and the disturbance of consciousness of the child were observed. There was a significant correlation between the time and the recovery degree of the children within half a year after injury. There was a low or weak correlation between the decrease of the mean FA value of visual lesion and the time of disturbance of consciousness in the children and the recovery degree of the children in half a year after injury, and there was a low or weak correlation between the average FA value of the visual lesion and the recovery degree of the children in the first half of the year after injury (P 0.103rU 0.487P0.003r-0.241T 0.169r-0.229P 0.1922). The correlation between the decrease of the average FA value of the line site and the average FA value of the visible lesion and the recovery degree of the children half a year after injury was higher than that of the GCS score. Conclusion DTI is a sensitive method for the diagnosis of DAI. It is more valuable to judge the degree of injury and prognosis of children with DAI than the commonly used GCS score.
【作者单位】：重庆医科大学附属儿童医院放射科/儿童发育疾病研究教育部重点实验室/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室;重庆医科大学附属儿童医院小儿外科(国家重点临床专科)神经外科;
【基金】：重庆市科委科技攻关(应用技术研发类)基金资助项目(cstc2012gg-yyjs10013)
【分类号】：R445.2;R726.5

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