Imaging analysis of diffuse axonal injury

SHI Li-xin; WANG Qing-tao; ZANG Ying-zhuo; HE Bin; ZHANG Wen-chao; WANG Chuan-hai

doi:10.3969/j.issn.1009-4237.2017.01.010

Abstract：Objective To investigate imaging features of cerebral diffuse axonal injury ( DAI) and its diag-nostic value .Methods The clinical data , low field MRI data and CT imaging of 26 DAI patients enrolled from Sep.2010 to Sep.2015 were retrospectively analyzed .Among them 19 were males and 7 were females with an aver-age of 34.6(16-65) years.Twenty-two cases were injured from traffic accidents ,3 were from high falling and one was from heavy objects .All patients had trauma history .Patients developped immediate coma or continuous coma . According to the GCS score after hospitalization ,4(GCS≤8) were severe,6(9-12) were moderate and 16(13-15) were mild.Results All 26 patients were diagnosed with CT and low field MRI .The main manifestations were in-tracranial lesions in single or multiple sites .DAI lesions included hemorrhagic and non hemorrhagic lesions ,mainly distributed in the gray matter junction area ,basal ganglia area,thalamus,deep white matter,corpus callosum area, etc..The sensitivity of low field MRI was significantly higher than that of CT (χ2 =14.567,P=0.012).The GRE-T2*W1 sequence (97.59%) was the highest in all the sequences of hemorrhagic lesions ,and the DWI sequence (95.18%) was the highest in all the sequences of non hemorrahagic lesions .Conclusion The early diagnosis of DAI with CT and low field MRI is very valuable .The low field MRI can make up for the CT negative examination of the patients with heavy brain injury ,and can significantly improve the detection rate ,diagnosis rate ,and effectively a-void misdiagnosis and improve the prognosis .