磁共振彌漫張量成像對兒童彌漫性軸索損傷程度評估的定量研究
發(fā)布時間:2018-03-24 21:27
本文選題:彌漫性軸索損傷 切入點:磁共振成像 出處:《重慶醫(yī)學》2017年30期
【摘要】:目的比較磁共振彌漫張量成像(DTI)各向異性分數(shù)(FA)與入院時格拉斯哥意識障礙量表(GCS)對兒童彌漫性軸索損傷(DAI)患者損傷程度及預后判斷的價值。方法 34例DAI患兒入院時采用GCS評分評價意識障礙程度,傷后2周內(nèi)行DTI檢查。健康體檢者23例行DTI檢查。測量各部位可視性病灶區(qū)和健側(cè)對稱處FA值及腦中線部位FA值,計算中線部位平均FA值降低程度及可視性病灶平均FA值降低程度。分析GCS評分、可視性病灶平均FA值降低程度及腦中線部位平均FA值與患兒意識障礙時間及傷后半年患兒恢復程度的相關性。結果腦中線部位平均FA值降低程度與患兒意識障礙時間及傷后半年患兒恢復程度呈顯著相關(r=0.519,P=0.002;r=0.669,P=0.000);可視性病灶平均FA值降低程度及GCS評分與患兒意識障礙時間及傷后半年患兒恢復程度均呈低度相關或微弱相關(r=0.285,P=0.103;r=0.487,P=0.003;r=-0.241,P=0.169;r=-0.229,P=0.192)。腦中線部位平均FA值降低程度及可視性病灶平均FA值降低程度與傷后半年患兒恢復程度的相關性高于GCS評分。結論 DTI為診斷DAI的敏感方法,較臨床普遍采用的GCS評分對DAI患兒的損傷程度及預后判斷更有價值。
[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.
【作者單位】: 重慶醫(yī)科大學附屬兒童醫(yī)院放射科/兒童發(fā)育疾病研究教育部重點實驗室/兒童發(fā)育重大疾病國家國際科技合作基地/兒科學重慶市重點實驗室;重慶醫(yī)科大學附屬兒童醫(yī)院小兒外科(國家重點臨床?)神經(jīng)外科;
【基金】:重慶市科委科技攻關(應用技術研發(fā)類)基金資助項目(cstc2012gg-yyjs10013)
【分類號】:R445.2;R726.5
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