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目的探讨表观弥散系数(ADC)值在预测急性一氧化碳中毒迟发性脑病发生中的价值。方法 122例急性一氧化碳中毒病例,依据是否发生急性一氧化碳中毒迟发性脑病分为无迟发性脑病组(84例)和迟发性脑病组(38例)。对每一例病例均进行扩散加权成像(DWI)检查及平均ADC值测量。采用独立样本双侧t检验对迟发性脑病组与无迟发性脑病组组间相同部位的平均ADC值进行分析。结果急性一氧化碳中毒迟发性脑病的发病率为31.1%(38/122);与无迟发性脑病组的(0.729±0.036)×10~(-3)mm~2/s和(0.754±0.019)×10~(-3)mm~2/s比较,迟发性脑病组半卵圆中心区、侧脑室周围白质区的平均ADC值为(0.703±0.065)×10~(-3) mm~2/s和(0.719±0.068)×10~(-3) mm~2/s,差异均有统计学意义(P<0.05),两组苍白球区、皮质区平均ADC值比较差异无统计学意义(P>0.05)。结论脑白质区平均ADC值的下降对预测急性一氧化碳中毒迟发性脑病出现更有价值。
Objective To investigate the value of apparent diffusion coefficient (ADC) in predicting the occurrence of delayed encephalopathy after acute carbon monoxide poisoning. Methods A total of 122 cases of acute carbon monoxide poisoning were divided into two groups according to whether they had acute carbon monoxide poisoning or not, 84 patients with no delayed encephalopathy and 38 patients with delayed encephalopathy. Diffusion-weighted imaging (DWI) and mean ADC measurements were performed on each case. Two-sided t-test with independent samples was used to analyze the mean ADC values of the same site between late encephalopathy group and non-delayed encephalopathy group. Results The incidence of delayed encephalopathy was 31.1% (38/122) in patients with acute carbon monoxide poisoning and (0.729 ± 0.036) × 10 -3 mm 2 / s and (0.754 ± 0.019 ) × 10 ~ (-3) mm ~ 2 / s, the average ADC value of the centrum semilunar and the periventricular white matter in the delayed encephalopathy group was (0.703 ± 0.065) × 10 ~ (-3) mm ~ 2 / s and (0.719 ± 0.068) × 10 ~ (-3) mm ~ 2 / s, the differences were statistically significant (P <0.05). There was no significant difference in average ADC value between the two groups Significance (P> 0.05). Conclusion The decrease of mean ADC value in white matter area is more valuable in predicting delayed encephalopathy of acute carbon monoxide poisoning.