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Objective: To investigate the susceptibility weighted imaging (susceptibility-weighted imaging, SWI) and diffusion tensor imaging (diffusion tensor imaging, DTI), technology due to hemorrhage and axonal injury in traumatic brain injury (traumatic brain inj ury, TBI) joint applications, and to assess the correlation of imaging findings and clinical Glasgow Coma Score (Glasgow coma scale, GCS), Glasgow Outcome Score (Glasgow Outcome Scale, GOS). Materials and Methods: 25 patients with TBI patients (18 males, 7 females, age 6-67 years, mean age 36.88 years) and 30 age-and sex-matched healthy volunteers controlled study of MR and CT. Of all TBI patients experienced physicians from neurosurgery GCS, GOS score; follow the GCS score is divided into mild (n = 13) and moderate to severe (n = 12). From the trauma to the MR examination time, the patients were divided into acute (within one week) (n = 8), subacute (1 week to 1 month) (n = 17); and in patients with post-traumatic 6 - The GOS score within 12 months, divided into good prognosis (n = 19), and poor prognosis (n = 6) two categories. Philips Brilliance6 platoon and GE 16-row MSCT scanner and the GE Signa HD1.5T magnetic resonance scanner, scan sequence include: axial T1WI and T2WI, DTI and SWI. Using the GE ADW4.3 the workstation Functool data processing, SWI minimum intensity projection image (SWIminp) to observe the performance of traumatic brain hemorrhage stove, SPIN (Signal process in NMR) software measurement the SWIminp and CT images of the area and the number of hemorrhagic foci. Utilize the GE Adw 4.3 workstation Functool software processing, fractional anisotropy (fractional anistrophy, FA) value and average diffusion coefficient (average diffusion coefficient, ADC) values ??of the relevant brain regions. DTI image anatomical regions artificially divided into 20 regions. FA value of CT and SWI control of the area and the number of hemorrhagic foci analysis, GSC, GOS correlation analysis, mild, moderate and severe traumatic brain injury patients with normal control group, ADC values ??control analysis, correlation analysis with GCS, GOS. Hemorrhagic foci number and area FA values ??of the correlation analysis between the ADC value. Results 1. ① TBI patients SWIminp image is larger than the area shown in the corresponding slice CT images hemorrhagic foci (P = 0.021), the number of bleeding lesions (P lt; 0.001); patients with moderate to severe mild displayed in SWI hemorrhagic foci area (P = 0.001), the number of bleeding lesions (P lt; 0.001), and SWI and CT images bleeding stove area, the number of clinical GCS score both obvious negative correlation '(P ≤ 0.001): ② SWI and CT showed poor prognosis of hemorrhagic foci area are greater than the good prognosis (P = 0.003, P = 0.002), CT display the number of the poor prognosis of hemorrhagic lesions with a good prognosis between the significant difference (P = 0.003) SWI display the number of the poor prognosis of hemorrhagic foci with good prognosis patients, there was no difference (P = 0.110); hemorrhagic foci area, the number of SWI and CT images with clinical GOS scores were correlated (P <0.001); in DTI study, normal control group with mild, moderate and severe trauma patients, FA values ??decreased number of brain regions and the degree of FA values ??decreased both the normal control group lt; the mild trauma patients lt; heavy trauma group; while ADC value to change the number of brain regions and changes in varying degrees. ② TBI patients, 65% (13/20) of the brain area FA values ??GOS score significantly (P lt; 0.05); 90% (18/20) ADC value of brain regions with GOS score no correlation. Bilateral frontal, temporal lobe, the area and the number of hemorrhagic foci and FA values ??were negatively correlated; were positively correlated with ADC values. Conclusion: cerebral hemorrhage and cerebral edema associated with brain trauma (TBI) and nerve fibers, axonal injury led to the severity of the patient's clinical symptoms and prognostic pathological changes, this study has select 25 cases from 53 cases of patients with traumatic brain injury complete CT, SWI, DTI image data and clinical information by controlled studies, the preliminary draw the following conclusions: 1.SWI than CT inspection and conventional MR sequences in the detection sensitivity of TBI patients with hemorrhagic foci and measuring the area of ??bleeding lesions number of other aspects has obvious advantages in the evaluation of TBI injury severity and prognostic evaluation of patients with clinical GCS score good correlation. 2.DTI can be sensitive detection TBI patients with pathological changes in white matter and microscopic change, which the FA values ??reflect TBI severity of brain injury and the prognosis of patients with obvious correlation; ADC value can reflect the pathological evolution of the TBI part of the area in different periods: two and the TBI clinical outcomes GOS score has relevance. 3.SWI in TBI patients with some brain regions detection of brain hemorrhage area and the number of DTI measurements FA value was a negative correlation; cerebral hemorrhage in some brain regions with ADC values ??were positively correlated. 4. Combination of both to reflect cerebral hemorrhage, but also reflect the functional MRI, cerebral edema and cerebral axonal injury SWI and DTI technology to help patients with traumatic brain injury accurate disease diagnosis and objective evaluation of the patient's prognosis. traumatic brain injury is a promising imaging examination, strategy.
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