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目的:探讨脑弥漫性轴索损伤(DAI)的临床表现、MRI诊断。方法:分析30例脑弥漫性轴索损伤的临床资料及MRI图像资料,其中24例还先后做过CT检查,同时对所有病例进行GCS评分。结果:DAI的MRI征象主要表现为弥漫性脑肿胀,双侧脑白质水肿,脑室、脑池、脑沟及蛛网膜下腔变窄消失,无中线移位。脑实质出血20例,呈斑点状,直径大多小于2.0cm,主要位于胼胝体、脑干、小脑,基底节区及皮髓交界处,蛛网下腔出血和/或脑室出血12例;合并硬膜外血肿5例;颅骨骨折6例。结论:DAI根据临床表现及影像学检查,可作出临床诊断,MRI对DAI具有较高的诊断价值,可弥补CT的局限性,对临床早期诊断、治疗以及评价预后具有重要价值。
Objective: To investigate the clinical manifestations and MRI diagnosis of diffuse axonal injury (DAI) in the brain. Methods: The clinical data and MRI images of 30 patients with diffuse axial axonal injury were analyzed. Twenty - four of them were examined by CT and the GCS scores of all cases were also evaluated. Results: The MRI signs of DAI mainly showed diffuse brain swelling, bilateral white matter edema, narrowing of ventricles, cerebral pools, sulci and subarachnoid space disappeared without central line shift. Encephalic hemorrhage in 20 cases, spotted, mostly less than 2.0cm in diameter, mainly located in the corpus callosum, brainstem, cerebellum, basal ganglia and cutaneous junction, subarachnoid hemorrhage and / or ventricular hemorrhage in 12 cases; combined with epidural Hematoma in 5 cases; skull fracture in 6 cases. Conclusion: DAI can make clinical diagnosis according to clinical manifestations and imaging examination. MRI has high diagnostic value on DAI and can make up for the limitations of CT. It is of great value in the early diagnosis, treatment and prognosis evaluation.