The Clinical Application Of Susceptibility Weighted Imaging In Combination With Diffusion Weighted Imaging In The Diagnosis And Prognostic Evaluation Of Diffuse Axonal Injury

Objective:The purpose of this work was to compare susceptibility weighted imaging (SWI) and diffusion weighted imaging(DWI) with conventional MRI sequences,and explore the clinical value of SWI and DWI in the diagnosis and prognostic evaluation of diffuse axonal injury(DAI) of the brain.Methods:sixty-four patients with DAI were scanned at head CT and3.0T MRI,including sequences of T1WI,T2WI,DWI and SWI. Then we analysis their respective signal and characteristics of distribution, and recognized differences between the detection rate and volume of each series,and research the relevance among the detection numbers,volume in MRI espicially in SWI and DWI with the GCS score and GOS score.Results:DAI lesions were mainly distributed in the cerebral cortex, junctional zone,white matter, corpus callosum, brain stem, cerebellum and basal ganglia and other areas;and they were scattered unevenly with different size,different shapes such as round, oval, beaded, patchy, cord-like,and different signals such as low signal,high signal,and "bird’s eye-like" lesions with an intermediate low signal surrounded by high signal. SWI could obviously demonstrate the cerebral microbleeds more than that by T1WI,T2WI and DWI(P<0.01),while DWI could display the cerebral edema lesions more obviously than T1WI,T2WI and SWI (P<0.01); The detected lesions volume of SWI and DWI were significantly higher than those of TIWI and T2WI,and the detected lesion volume differences between SWI and DWI were also significant (U=1394.000, P<0.01). The cerebral microbleeds number,total number and volume of detected lesions in SWI and The edema lesions number,cerebral microbleeds number,total number and volume of detected lesions in DWI and total DAI lesions numbers of main locations were negatively correlated with the corresponding GCS scores and the GOS score scored3months after traumatic brain injury (P<0.05); the edema lesions number of detected lesions in SWI were also negatively correlated with the GOS scores3months after traumatic brain injury (P<0.05). In this study, through the multiple linear regression analysis about the factors affecting GCS scores,GOS scores of DAI patients,we also found that:①GCS score at admission=11.454-0.115*the lesions number of corpus callosum-0.055*the lesions number of white matter;②GCS score1h before examination=15.270-0.151*the lesions number of brainstem-0.100*the lesions number of corpus callosum-0.036the lesions number of the junction of leather and cord;③GOS score after3months after traumatic brain injury=5.339-0.017*the lesions number of the junction of leather and cord-0.068*the lesions number of brainstem.Conclusion:SWI in combination with DWI could provide great help for DAI patients with post-traumatic intracerebral microhemorrhage and edema lesions, for DAI’s early clinical diagnosis and prognosis assessment, and thus SWI and DWI should be the normal and first choice among various sequences of MR imagining.