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医学临床研究  2023, Vol. 40 Issue (9): 1392-1395    DOI: 10.3969/j.issn.1671-7171.2023.09.031
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扩散加权成像和表观扩散系数值在一氧化碳中毒迟发性脑病中的诊断价值
李小娟, 郝少, 詹晓飞*
铜川矿务局中心医院核磁共振室,陕西 铜川 727000
Diagnostic Value of Diffusion Weighted Imaging and Apparent Diffusion Coefficient Values in Delayed Encephalopathy Caused by Carbon Monoxide Poisoning
LI Xiaojuan, HAO Shao, ZHAN Xiaofei
MRI Room,The Central Hospital of Tongchuan Mining Bureau,Tongchuan Shaanxi 727000
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摘要 【目的】探讨扩散加权成像和表观扩散系数值(DWI-ADC)诊断一氧化碳(CO)中毒迟发性脑病的价值。【方法】选择2020年2月至2022年2月本院收治的120例急性CO中毒患者,采用核磁共振成像(MRI)的4个不同序列对全部患者进行检查并计算扩散系数值(ADC),分析CO中毒患者病灶分布情况,比较MRI检查中不同扫描序列中不同病灶区域病灶检出数量,采用Spearman分析CO中毒患者严重程度与ADC值的相关性。【结果】120例患者中,轻度中毒患者有35例MRI无异常表现,占比为68.30%(35/52);中度中毒患者有14例MRI无异常表现,占比为25.45%(14/55);重度中毒患者有2例为迟发性脑病,占比为15.38%(2/13)。不同病灶区域不同序列扫描中,DWI检出病灶数量显著高于TSE-T2WI、SE-T1WI、FLAIR-T2WI,差异有统计学意义(P<0.05)。不同CO中毒严重程度患者脑皮质区ADC值比较,差异无统计学意义(P>0.05);与轻度相比,中度、重度、迟发性脑病的半卵圆中心、侧脑室旁脑白质、苍白球区的ADC值均明显降低,且重度ADC值低于中度,迟发性脑病ADC值低于重度、中度,差异均有统计学意义(均P<0.05)。Spearman相关性分析显示,CO中毒严重程度与半卵圆中心、侧脑室旁脑白质、苍白球区的ADC值呈负相关性(均P<0.05)。【结论】DWI-ADC可以预测患者CO中毒迟发性脑病的发生风险,DWI信号越高,ADC值越小,提示患者脑白质脱髓鞘受损越严重,并发迟发性脑病的风险越大。
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李小娟
郝少
詹晓飞
关键词 一氧化碳中毒/并发症脑疾病/诊断弥散磁共振成像/方法    
Abstract:【Objective】To explore the value of diffusion weighted imaging and apparent diffusion coefficient (DWI-ADC) in the diagnosis of delayed encephalopathy caused by carbon monoxide (CO) poisoning.【Methods】A total of 120 patients with acute CO poisoning admitted to our hospital from February 2020 to February 2022 were selected. Four different sequences of magnetic resonance imaging (MRI) were used to examine all patients and calculate the apparent diffusion coefficient value (ADC). The distribution of lesions in CO poisoning patients was analyzed,and the number of lesions detected in different lesion areas in different scanning sequences during MRI examination was compared. Spearman was used to analyze the correlation between the severity of CO poisoning patients and ADC values.【Results】Among the 120 patients with mild poisoning,35 had no abnormal MRI findings,accounting for 68.30% (35/52); 14 patients with moderate poisoning had no abnormal MRI findings,accounting for 25.45% (14/55); Two patients with severe poisoning had delayed encephalopathy,accounting for 15.38% (2/13). In different lesion areas and sequences of scans,the number of lesions detected by DWI was significantly higher than that on TSE-T2WI,SE-T1WI,and FLAIR-T2WI,with a statistically significant difference (P<0.05). There was no statistically significant difference in ADC values in the cerebral cortex of patients with different levels of CO poisoning (P>0.05); Compared with mild encephalopathy,the ADC values in the central half oval,paraventricular white matter,and globus pallidus of moderate,severe,and delayed onset encephalopathy were significantly reduced. Moreover,the ADC value of severe encephalopathy was lower than that of moderate,and the ADC value of delayed encephalopathy was lower than that of severe and moderate,with statistical significance (all P<0.05). Spearman correlation analysis showed that the severity of CO poisoning was negatively correlated with ADC values in the central oval,paraventricular white matter,and globus pallidus regions (all P<0.05).【Conclusion】DWI-ADC can predict the risk of delayed encephalopathy caused by CO poisoning in patients. The higher the DWI signal,the smaller the ADC value,indicating more severe white matter demyelination damage in patients,and the greater the risk of concurrent delayed encephalopathy.
Key wordsCarbon Monoxide Poisoning/CO    Brain Diseases/DI    Diffusion Magnetic Resonance Imaging/MT
收稿日期: 2022-11-18     
中图分类号:  R595.1  
通讯作者: *E-mail:1007464527@qq.com   
引用本文:   
李小娟, 郝少, 詹晓飞. 扩散加权成像和表观扩散系数值在一氧化碳中毒迟发性脑病中的诊断价值[J]. 医学临床研究, 2023, 40(9): 1392-1395.
LI Xiaojuan, HAO Shao, ZHAN Xiaofei. Diagnostic Value of Diffusion Weighted Imaging and Apparent Diffusion Coefficient Values in Delayed Encephalopathy Caused by Carbon Monoxide Poisoning. JOURNAL OF CLINICAL RESEARCH, 2023, 40(9): 1392-1395.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.09.031     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I9/1392
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