Multi-sequence MRI Combined With CT In The Evaluation Of The Condition And Prognosis Of Craniocerebral Injury

Objective: The purpose is to compare the diagnostic value of different imaging examinations such as CT and MRI for Traumatic Brain Injury(TBI),to evaluate the value of magnetic sensitive T2 Star-Weighted Angiogtaphy(SWAN)examination for Traumatic Brain Injury(TBI),to discuss the correlation between the number of cerebral micro bleed after TBI and clinical symptoms and long-term recovery outcome and finally to help making more accurate clinical prognoses based on the early clinical judgement and assessment of patients with TBI.Methods: The data were collected from the individuals who have visited the First Affiliated Hospital of Hunan University of Chinese Medicine from January 2016 to January 2018.All patients were evaluated by 2 senior neurosurgical physicians for detailed medical history including age,gender,factors of injury,Glasgow Coma Scale(GCS)and neurological symptoms and etc.The selected 42 patients,who met the criteria,had received brain CT,MRI TIWI,T2 WI,Fluid Attenuation Inversion Recovery(Fl AIR),Diffusion Weighted Imaging(DWI),and SWAN examination within 3 days of admission to hospital.The number of lesions,morphology,etc.were investigated on CT and MRI sequences.The patients were paid a follow-up visit in the next 3 months after the injury.Neurological symptoms were recorded and then assessed by Glasgow Outcome Scale(GOS).A statistical comparative analysis was made on the basis of the data collected.Results: Among the 42 patients,there were 33 cases of Mild Traumatic Brain Injury and 9 cases of Moderate Traumatic Brain Injury.There were 27 males and 15 females.The male to female ratio was 1.8:1 and the average age was 45.5.Traffic accidents and high-altitude crashes were the main causes of TBI.There were 24 cases,25 cases,28 cases,29 cases,and 37 cases who had intracranial organic injury according to CT,T2 WI,FLAIR,DWI,and SWAN results.The number of lesions were 89,96,147,131,and 545 respectively.The detection rate of lesions through SWAN was significantly higher than that through CT,T2 WI,FLAIR,and DWI and the P value was 0.000.The detection rate of FLAIR was higher than that of DWI and T2 WI.The P values were 0.021 and 0.000 respectively.The detection rate of DWI was higher than that of T2 WI and the P value was 0.000.There was no significant statistical difference between CT and T2 WI on detection rate and P value was 0.182(Wilcoxon paired rank sum test).The GCS score on admission to hospital was negatively correlated with the number of lesions detected on SWAN,with a correlation coefficient R of-0.810 and a P value of 0.000.The GOS score after 3 months was negatively correlated with the number of lesions detected by SWAN with a correlation coefficient R of-0.707 and the P value was 0.000(spearman correlation analysis).The greater the number of lesions detected by SWAN,the lower the GCS coma scale,the lower the GOS outcome score,the more critical is the condition.There were 17 cases of TBI who had developed Post-Traumatic Brain Syndrome(PTBS).The number of lesions detected by SWAN and the GOS score were associated with PTBS,with a P value of 0.000(Wilcoxon independent rank sum test).The more lesions detected by SWAN,the higher the incidence of PTBS;the higher the incidence of PTBS,the lower the GOS score and the worse the outcome.Conclusion:SWAN shows higher sensitivity than CT and conventional MRI in detecting hemorrhagic focus of TBI patients.The number of hemorrhagic lesions in brain parenchyma is directly related to the severity of the patient's illness and the long-term prognosis.SWAN combined with CT can provide a more accurate basis.