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首页> 外文期刊>Neurocirugia >Resonancia magnética en trauma craneal moderado y grave: estudio comparativo de hallazgos en TC y RM. Características relacionadas con la presencia y localización de lesión axonal difusa en RM
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Resonancia magnética en trauma craneal moderado y grave: estudio comparativo de hallazgos en TC y RM. Características relacionadas con la presencia y localización de lesión axonal difusa en RM

机译：中度和重度颅脑外伤的磁共振成像：CT和MRI检查结果的比较研究。 MRI上与弥漫性轴索病变的存在和位置有关的特征。

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Introduction. Cranial CT has been the most extended evaluation means for patients suffering head trauma. However, it has low sensitivity in the identification of diffuse axonal injury and posterior fossa lesions. Cranial MR is a potentially more sensitive test but difficult to perform in these patients, a fact that has hampered its generalised use. Objective. To compare the identification capability of traumatic intracranial lesions by both diagnostic tests in patients with moderate and severe head injury and to determine which radiological characteristics are associated with the presence of diffuse injury in MR and their clinical severity. Material and methods. 100 patients suffering moderate or severe head injury to whom a MR had been performed in the first 30 days after trauma were included. All clinical variables related to prognosis were registered, as well as the data from the initial CT following Marshall et al., classification. The MR was blindly evaluated by two neuroradiologists that were not aware of the initial CT results or the clinical situation of the patient. All lesions were registered as well as the classification following the classification of lesions related to DAI described by Adams et al. CT and MR findings were compared evaluating the sensitivities of each test. Factors related to the presence of diffuse injury in MR were studied by univariate analysis using χ2 test and simple correlations. Results. MR is more sensitive than CT for lesions in cerebral white matter, corpus callosum and brainstem. It also detects a greater number of cerebral contussions. The presence of diffuse axonal injury depends on the mechanism of the trauma, being more frequent in higher energy trauma, specially in traffic accidents. Among the radiological characteristics associated to DAI the most clearly related is intraventricular haemorrhage. The presence of a deeper injury and a higher score in the scales of Adams is associated with a lower score in the GCS and motor GCS, and so with a worse level of consciousness and bigger severity of injury, confirming Ommaya's model.
机译：介绍。颅脑CT已经成为对颅脑外伤患者最广泛的评估手段。但是，它在弥漫性轴索损伤和后颅窝病变的识别中灵敏度较低。颅脑MR是一种可能更敏感的检测方法，但在这些患者中难以执行，这一事实妨碍了其普遍使用。目的。为了通过中度和重度颅脑损伤患者的诊断测试来比较创伤性颅内病变的识别能力，并确定哪些放射学特征与MR中弥散性损伤的存在及其临床严重程度有关。材料与方法。包括100名遭受中度或重度颅脑损伤的患者，他们在创伤后的前30天进行了MR检查。记录所有与预后相关的临床变量，以及Marshall等进行分类后的初始CT数据。 MR是由两名不知道最初的CT结果或患者临床状况的神经放射科医生盲目评估的。根据Adams等人描述的与DAI相关的病变分类，所有病变均进行了注册以及分类。比较了CT和MR的发现，以评估每个测试的敏感性。通过使用χ2检验和简单相关性进行单变量分析，研究了与MR中弥散性损伤相关的因素。结果。对于脑白质，call体和脑干的病变，MR比CT敏感。它还可以检测到更多的脑挫伤。弥漫性轴索损伤的存在取决于创伤的机理，在高能创伤中更常见，特别是在交通事故中。在与DAI相关的放射学特征中，最明显相关的是脑室内出血。亚当斯量表的更深损伤和较高得分的存在与GCS和运动GCS的得分较低相关，因此意识水平较差且损伤的严重程度较高，这证实了Ommaya的模型。

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