Intraventricular hemorrhage on initial computed tomography as marker of diffuse axonal injury after traumatic brain injury.
Intraventricular hemorrhage on initial computed tomography as marker of diffuse axonal injury after traumatic brain injury.
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初始计算机断层扫描的脑室内出血作为创伤性脑损伤后弥漫性轴突损伤的标志。
DOI：
10.1089/neu.2014.3453
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Takahashi S.
中科院分区：
文献类型：
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作者：
Mata-Mbemba D;Mugikura S;Nakagawa A;Murata T;Kato Y;Tatewaki Y;Li L;Takase K;Ishii K;Kushimoto S;Tominaga T;Takahashi S.
据报告，初次计算机断层扫描（CT）显示的脑室内出血（IVH）可预测随后磁共振成像（MRI）显示的胼胝体（CC）弥漫性轴索损伤（DAI）病变。我们的目的是研究初始CT表现与MRI检测到的DAI病变之间的关系，以及IVH严重程度（IVH评分）与DAI严重程度（DAI分期）之间的关系。连续140例外伤性脑损伤（TBI）患者在发病后30天内进行了MRI复查。我们回顾了他们的初始CT的以下六个结果：基底池的状态，中线移位的状态，硬膜外血肿，IVH，蛛网膜下腔出血，出血性肿块的体积和IVH评分分配在每个病人。根据MRI结果，将患者分为DAI组和非DAI组，并分配DAI分期。然后，为了证实初始CT上的IVH预测MRI上的DAI病变，我们对包括IVH在内的六种CT表现进行了多变量分析，并检查了IVH评分与DAI分期之间的关系。CT检测到的IVH是DAI的唯一预测因素（p=0.0139）。IVH评分与DAI分期呈正相关（p<0.0003）。DAI 3期（DAI累及脑干;p=0.0025）或2期（DAI累及CC;p=0.0042）的IVH评分显著高于DAI 0期（无DAI病变）。总之，初始CT上的IVH是随后MRI上DAI的唯一标志物，特别是重度DAI（2期或3期）。
Intraventricular hemorrhage (IVH) on initial computed tomography (CT) was reported to predict lesions of diffuse axonal injury (DAI) in the corpus callosum (CC) on subsequent magnetic resonance imaging (MRI). We aimed to examine the relationship between initial CT findings and DAI lesions detected on MRI as well as the relationship between the severity of IVH (IVH score) and severity of DAI (DAI staging). A consecutive 140 patients with traumatic brain injury (TBI) who underwent MRI within 30 days after onset were revisited. We reviewed their initial CT for the following six findings: Status of basal cistern, status of mid-line shift, epidural hematoma, IVH, subarachnoid hemorrhage, and volume of hemorrhagic mass and IVH score were assigned in each patient. Based on MRI findings, patients were divided into DAI and non-DAI groups and were assigned a DAI staging. Then, to confirm that the IVH on initial CT predicts DAI lesions on MRI, we used multi-variate analysis of the six CT findings, including IVH, and examined the relationship between IVH score and DAI staging. The IVH detected on CT was the only predictor of DAI (p=0.0139). The IVH score and DAI staging showed significant positive correlation (p<0.0003). IVH score in DAI stage 3 (with DAI involving the brain stem;p=0.0025) or stage 2 (with DAI involving CC;p=0.0042) was significantly higher than that of DAI stage 0 (no DAI lesions). In conclusion, IVH on initial CT is the only marker of DAI on subsequent MRI, specifically severe DAI (stage 2 or 3).