Kelly A B, Zimmerman R D, Snow R B, Gandy S E, Heier L A, Deck M D
Department of Radiology, New York Hospital-Cornell Medical Center, NY 10021.
AJNR Am J Neuroradiol. 1988 Jul-Aug;9(4):699-708.
The results of CT and MR imaging were reviewed retrospectively and compared in 100 patients who experienced clinically significant head trauma. The findings were analyzed on the basis of several parameters in an attempt to establish objective clinical guidelines for the use of each diagnostic technique. CT remains the screening method of choice in evaluating acute severe head trauma; however, MR revealed additional clinically relevant findings in all four cases in which the patient's clinical symptoms were disproportionate to the CT findings. MR was equal or superior to CT in the evaluation of all patients with acute minor head trauma and in 94 of 95 patients examined in the subacute, chronic, or remote phase of injury, irrespective of the severity or pathologic nature of their injuries. All subacute contusions (21 lesions) and white-matter shearing lesions (18 cases) were demonstrated to particular advantage on MR compared with CT, as were all subdural hematomas (of 52 small subdural collections, 58% were detected only by MR). Although surgical management was not altered by the additional information provided by MR, the implications regarding the medical management and disposition of the patients with head trauma were significant.
对100例有临床显著头部创伤的患者的CT和MR成像结果进行了回顾性分析并比较。根据几个参数对结果进行分析，试图为每种诊断技术的使用建立客观的临床指南。CT仍然是评估急性重度头部创伤的首选筛查方法；然而，在4例患者临床症状与CT表现不成比例的病例中，MR均显示出额外的临床相关发现。在评估所有急性轻度头部创伤患者以及95例处于损伤亚急性、慢性或远期阶段的患者中，无论损伤的严重程度或病理性质如何，MR与CT相当或优于CT。与CT相比，所有亚急性挫伤（21个病灶）和白质剪切损伤（18例）在MR上显示出特别的优势，所有硬膜下血肿也是如此（在52个小的硬膜下血肿中，58%仅通过MR检测到）。虽然MR提供的额外信息未改变手术治疗方案，但对头部创伤患者的医疗管理和处置的影响是显著的。
