磁共振及其波谱对重型颅脑损伤预后判断的临床研究

发布时间：2018-03-13 15:46

  本文选题：重型颅脑损伤　切入点：磁共振波谱　出处：《南昌大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对重型颅脑损伤患者伤后进行MRI及MRS检查,并将检查结果与患者的预后结果之间的关系进行统计学分析,探索MRI与MRS对重型颅脑损伤预后判断的临床意义。方法:选取2010年1月到2014年5月在我院接受CT检查及综合治疗的27例急性重型颅脑损伤患者,入院7d内进行头颅MRI及MRS检查,采用核磁共振扫描仪及超导磁共振进行T1、T2、Flair序列扫描,选择合适的靶点进行MRS检查,明确颅脑损伤的部位及性质。对头颅CT、MRI及MRS的弥漫性轴索损伤影像学图片及资料进行比照,并且对比头颅CT与MRI+MRS对弥漫性轴索损伤其中包括原发性脑干损伤的检出率,并分析MRS检出损伤部位及检出指标与预后的关系。结果:在对重型颅脑损伤中弥漫性轴突损伤包括原发性脑干损伤的检出率方面,头部MRI+MRS检查的检出率明显高于头部CT检查(P0.05);6个月后预后评分,GOS4~5分患者的NAA/Cr、NAA/Cho、Cho/Cr比值与1~3分患者的差异显著(P0.05);Barthal评分60分患者的NAA/Cr、NAA/Cho、Cho/Cr比值与60~41分和≤40分患者的差异显著(P0.05);重型颅脑损伤病人的损伤位置不同,其预后具有显著差异(P0.05)。结论:MRI+MRS检查能够提高重型颅脑损伤病变的检出率,早期进行MRI和MRS检查有利于评估预后。
[Abstract]:Objective: to analyze the relationship between the results of MRI and MRS and the prognosis of patients with severe craniocerebral injury. To explore the clinical significance of MRI and MRS in judging the prognosis of severe craniocerebral injury methods: 27 patients with acute severe craniocerebral injury who received CT examination and comprehensive treatment from January 2010 to May 2014 were examined with MRI and MRS within 7 days after admission. The T _ 1T _ 2T _ 2 flair sequence was scanned by MRI scanner and superconducting magnetic resonance imaging. The location and nature of craniocerebral injury were determined by MRS, and the imaging images and data of diffuse axonal injury of head CT and MRS were compared. The detection rate of diffuse axonal injury, including primary brainstem injury, was compared between CT and MRI MRS. Results: the detection rate of diffuse axonal injury including primary brainstem injury in severe craniocerebral injury was analyzed. The positive rate of head MRI MRS examination was significantly higher than that of head CT scan (P 0.05), and the difference of NAA / Cr ratio between NAA / Cr / NAA / NAA / Choo / Cr ratio and 1 ~ 3 score in patients with prognostic score of 4 ~ 5 months after 6 months was significantly higher than that in patients with 60 points of NAA / Cr / NAA / NAA / Choo / Cr ratio of 60 ~ 41 points and 鈮，

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