医学英语听读Diffusea

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MRI：

MRIisthemodalityofchoiceforassessingsuspecteddiffuseaxonalinjuryeveninpatientswithentirelynormalCTofthebrain.MRI,especiallySWIorGREsequences,exquisitelysensitivetoparamagneticbloodproductsmaydemonstratesmallregionsofsusceptibilityartefactatthegrey-whitematterjunction,inthecorpuscallosumorthebrainstem.Somelesionsmaybeentirelynon-hemorrhagic(evenusinghighfieldstrengthSWIsequences).Thesewill,however,bevisibleasregionsofhighFLAIRsignal.

Overthefirstfewdays,thedegreeofsurroundingedemawilltypicallyincrease,althoughby3-monthspost-injuryFLAIRchangeswillhavelargelyresolved.Incontrast,SWIchangeswillusuallytakelongertoresolve,althoughby12-monthspost-injurytherewillhavebeensubstantialresolution.Thisistobeexpectedasedemaisfastertoresolvethanhemorrhage.

Importantly,itshouldbenoted,thatevenwithhighfieldstrengthmodernscanners,theabsenceoffindingsdoesnotcategoricallyexcludethepresenceofaxonalinjury.

Differentialdiagnosisonimagingconsider：

-corticalcontusions

themaindifferentialinpatientswithheadinjuries

typicallylocatedsuperficially,involvingthecortex(ratherthanatthegrey-whitematterjunction)andareusuallyassociatedwithvariableamountsofextra-axialblood(subarachnoidandsubdural)

-diffusevascularinjuries

-particularlyonT2*sequences

amyloidangiopathy

chronichypertensiveencephalopathy

cavernomatypeIV

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医院放射科副主任医师杨敏洁

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