Application of SWAN technology in DAI diagnosis classification and prognosis evaluation

doi:10.3877/cma.j.issn.2095-9141.2016.06.002

Abstract

Abstract:

Objective

To study the value of star weighted angiography (SWAN) in the diagnostic grading and prognostic evaluation of patients with brain DAI.

Methods

Fifty patients with brain DAI hospitalized in Department of Neurosurgery of Ji’nan Military General Hospital during 2013 January to 2015 March, were selected to receive 3.0T MRI, including sequences of T1WI、T2WI、FLAIR and SWAN. The number of the lesions and distributional characteristics in each sequence was analyzed. Furthermore, the correlativity of the grading and prognosis in patients with DAI in combination with GCS score and GOS score was also analyzed.

Results

(1) The detection rate of cerebral microbleeds through SWAN was significantly higher than that with the method of T1WI、T2WI and FLAIR. (2) SWAN detected lesion distribution, diffuse brain swelling and brain stem injury is closely related to the GCS score grading and GOS score. (3) The prognosis of DAI displayed polarization state, the higher grade of the GCS score, the lower of GOS score, and the greater value of the risk of death.

Conclusion

SWAN was a reliable method for the grading of clinical diagnosis and prognosis assessment in the patients of DAI after TBI, and the accuracy of diagnosis of DAI was second only to pathological diagnosis.

Key words: Diffuse axonal injury, Star weighted angiography, Cerebral microbleeds, Glasgow coma scale, Glasgow outcome scale

Xiaofang Hu, Xueming Lyu, Bo Li, Shaoji Yuan. Application of SWAN technology in DAI diagnosis classification and prognosis evaluation[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2016, 02(06): 328-333.

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Figures/Tables 5

References 20

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扫描层面	T1加权成像	T2加权成像	流动衰减反转恢复序列	磁敏感加权血管成像
经胼胝体干	14	33	59	316
经上丘和后连合	16	27	63	297
经小脑上脚	23	41	82	372
合计	53	101	204	985

扫描层面	T1加权成像	T2加权成像	流动衰减反转恢复序列	磁敏感加权血管成像
经胼胝体干	14	33	59	316
经上丘和后连合	16	27	63	297
经小脑上脚	23	41	82	372
合计	53	101	204	985

项目	?	DAI分级				χ²值	P值
项目	?	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	χ²值	P值
累及中线	无	9	8	6	1	21.890^*	0.000
累及中线	有	0	4	10	12	21.890^*	0.000
中线移位（5 mm）	无	9	7	10	8	5.759^*	0.129
中线移位（5 mm）	有	0	5	6	5	5.759^*	0.129
环池变化	无	8	8	7	3	10.600^*	0.012
环池变化	有	1	4	9	10	10.600^*	0.012
合并原发脑干损伤	无	9	11	10	4	15.313^*	0.001
合并原发脑干损伤	有	0	1	6	9	15.313^*	0.001
弥漫性脑肿胀	无	8	10	3	2	23.041^*	0.000
弥漫性脑肿胀	有	1	2	13	11	23.041^*	0.000
合并挫裂伤	无	6	7	10	8	0.300^*	1.000
合并挫裂伤	有	3	5	6	5	0.300^*	1.000
蛛网膜下腔出血	无	7	9	13	10	0.432^*	1.000
蛛网膜下腔出血	有	2	3	3	3	0.432^*	1.000

项目	?	DAI分级				χ²值	P值
项目	?	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	χ²值	P值
累及中线	无	9	8	6	1	21.890^*	0.000
累及中线	有	0	4	10	12	21.890^*	0.000
中线移位（5 mm）	无	9	7	10	8	5.759^*	0.129
中线移位（5 mm）	有	0	5	6	5	5.759^*	0.129
环池变化	无	8	8	7	3	10.600^*	0.012
环池变化	有	1	4	9	10	10.600^*	0.012
合并原发脑干损伤	无	9	11	10	4	15.313^*	0.001
合并原发脑干损伤	有	0	1	6	9	15.313^*	0.001
弥漫性脑肿胀	无	8	10	3	2	23.041^*	0.000
弥漫性脑肿胀	有	1	2	13	11	23.041^*	0.000
合并挫裂伤	无	6	7	10	8	0.300^*	1.000
合并挫裂伤	有	3	5	6	5	0.300^*	1.000
蛛网膜下腔出血	无	7	9	13	10	0.432^*	1.000
蛛网膜下腔出血	有	2	3	3	3	0.432^*	1.000

项目	?	GOS评分					χ²值	P值
项目	?	良好	较差	差	植物生存	死亡	χ²值	P值
累及中线（n=26）	无	17	2	2	1	2	34.901^*	0.000
累及中线（n=26）	有	0	2	3	4	17	34.901^*	0.000
中线移位（5 mm）（n=16）	无	17	2	3	2	10	15.067^*	0.002
中线移位（5 mm）（n=16）	有	0	2	2	3	9	15.067^*	0.002
环池变化（n=24）	无	13	2	2	2	7	6.593^*	0.163
环池变化（n=24）	有	4	2	3	3	12	6.593^*	0.163
合并原发脑干损伤（n=16）	无	16	3	4	3	7	14.073^*	0.003
合并原发脑干损伤（n=16）	有	1	1	1	2	12	14.073^*	0.003
弥漫性脑肿胀（n=27）	无	15	2	3	2	3	20.292^*	0.000
弥漫性脑肿胀（n=27）	有	2	2	2	3	16	20.292^*	0.000
合并挫裂伤（n=19）	无	9	3	4	3	12	1.603^*	0.861
合并挫裂伤（n=19）	有	8	1	1	2	7	1.603^*	0.861
蛛网膜下腔出血（n=11）	无	13	3	3	4	16	2.017^*	0.820
蛛网膜下腔出血（n=11）	有	4	1	2	1	3	2.017^*	0.820

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