本文選題：彌漫性軸索損傷　切入點(diǎn)：磁共振成像　出處：《重慶醫(yī)學(xué)》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?jǐn)?shù)(FA)與入院時(shí)格拉斯哥意識(shí)障礙量表(GCS)對(duì)兒童彌漫性軸索損傷(DAI)患者損傷程度及預(yù)后判斷的價(jià)值。方法 34例DAI患兒入院時(shí)采用GCS評(píng)分評(píng)價(jià)意識(shí)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(cè)量各部位可視性病灶區(qū)和健側(cè)對(duì)稱處FA值及腦中線部位FA值,計(jì)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(píng)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(shí)障礙時(shí)間及傷后半年患兒恢復(fù)程度的相關(guān)性。結(jié)果腦中線部位平均FA值降低程度與患兒意識(shí)障礙時(shí)間及傷后半年患兒恢復(fù)程度呈顯著相關(guān)(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(píng)分與患兒意識(shí)障礙時(shí)間及傷后半年患兒恢復(fù)程度均呈低度相關(guān)或微弱相關(guān)(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(fù)程度的相關(guān)性高于GCS評(píng)分。結(jié)論 DTI為診斷DAI的敏感方法,較臨床普遍采用的GCS評(píng)分對(duì)DAI患兒的損傷程度及預(yù)后判斷更有價(jià)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(xué)附屬兒童醫(yī)院放射科/兒童發(fā)育疾病研究教育部重點(diǎn)實(shí)驗(yàn)室/兒童發(fā)育重大疾病國(guó)家國(guó)際科技合作基地/兒科學(xué)重慶市重點(diǎn)實(shí)驗(yàn)室;重慶醫(yī)科大學(xué)附屬兒童醫(yī)院小兒外科(國(guó)家重點(diǎn)臨床專科)神經(jīng)外科;
【基金】：重慶市科委科技攻關(guān)(應(yīng)用技術(shù)研發(fā)類)基金資助項(xiàng)目(cstc2012gg-yyjs10013)
【分類號(hào)】：R445.2;R726.5

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本文編號(hào)：1660100