磁敏感加权成像及FLAIR序列在儿童创伤性颅内出血诊断中的价值

目的：探讨磁敏感加权成像（swI）及液体衰减反转恢复（FLAIR）序列在儿童创伤性颅内出血中的诊断价值。方法：36例颅脑外伤患儿，年龄3天～9岁，平均（2．6±2．6）岁。所有患者采用3．0TMR机进行T1.wT.T2wI、swI及FLAIR序列扫描。对比常规MRI序列（T1WI，T2WI）与swI和FLAIR序列三种检查方法在发现脑实质微出血（CMBs）、硬膜下或外出血、蛛网膜下腔出血（SAH）及脑室内出血的数量有关差异，并分析颅内各种出血的信号特点。结果：36例中常规MRI、SwI和FLAIR序列检出的脑实质微出血灶分别为80、197和65个，检出的硬膜下或外出血分别为45、45和44个部位，检出的SAH分别为7、10和13例，分别检出4、7和4例患儿存在脑室内出血。在检出脑实质微出血中，swI与常规MRI（X2=166．419，P=0．001）和FLAIR序列（X2=198．504，P=0．001）间差异有统计学意义（P〈0．05）。在检出SAH方面，FLAIR序列与常规MRI序列间差异有统计学意义（P=0．015）。颅内出血的信号特点较复杂，swI图像上颅内出血，尤其是硬膜下或外出血，可以表现为高信号或混杂信号。结论：swI较常规MRI和FLAIR序列能发现更多的微出血灶及脑室内出血，FLAIR序列在检出SAH方面具有独特的优势，综合应用MRI扫描序列对于儿童创伤性颅内出血的诊断及预后的判断有很高的价值。

MR susceptibility weighted imaging and FLAIR sequence in the diagnosis of children with traumatic intracranial hemorrhage

Objective：To investigate the value of MR susceptibility weighted imaging （SWI） and fluid attenuated in- version recovery （FLAIR） sequence in the diagnosis of children with traumatic intracranial hemorrhage. Methods： A total of 36 pediatric patients with traumatic brain injury and the age ranged from 3d～9y [（mean= 2.6± 2.6）y] were enrolled in this study. All patients underwent FLAIR sequence and SWI along with conventional MRI （cMRI） examination （including T1WI,T2WI） by a 3.0T MR scanner. The differences of the 3 approaches in displaying the volume of intracranial hemor- rhage including cerebral micro-bleeding （CMBs）, subdural/ extradural hemorrhage （SDH/EDH）,subarachnoid hemorrhage （SAH） and intraventricular hemorrhage （IVH） were compared,and the signal characteristics of various intracranial hemor- rhage were analyzed. Results： Of the 36 patients, cMRI, SWI and FLAIR detected 80,197 and 65 lesions of micro-bleeding respectively ; 45,45,44 lesions of SDH or EDH respectively; 7,10,13 cases of SAH and 4,7,4 cases with IVH respectively. In detecting microbleeding,there was significant difference between SWI and cMRI （P= 0. 001, X2 = 166. 419）, as well as between SWI and FLAIR （P=0. 001, X2 = 198. 504）. In detecting SAH, there was statistical difference between FLAIR and cMRI （P=0.015）. The signal appearances of intracranial hemorrhage were very complicated, and the hemorrhage signal es- pecially for SDH/EDH on SWI was either hyper-intensity or heterogeneous. Conclusion： When compared with cMRI and FLAIR, SWI can detect much more intra-cerebral micro-bleeding and IVH. FLAIR has obvious advantages superior to cMRI in detecting SAH. Thus, the use of comprehensive MRI sequences has significant value in the diagnosis and prognosis pre- diction for children with traumatic intreracranial hemorrhage.