The Prognosis Analysis Of CT Image With Early Stage Diffuse Axonal Injury

The prognosis analysis of CT image with early stage diffuse axonal injuryObjective Combining clinical characteristic, to analyse and evaluate the valueof the relationship between early period cerebral special CT image andprognosis of patients with diffuse axonal injury (DAI), so as to find a suitableradiological features for evaluating the state of DAI patients.Method1. The clinical data of110cases of patients with DAI, aged16-60years, fromthe department of neurosurgery, Ningxia medical university general hospitalfrom2010.10to2012.10were analysed through. To analyze the CT findings ofbrain for110cerebral stroke patients in the acute stage (after the onset within24hours). The data about regions of abnormal images in cranial CT (if minimalhemorrhagic focuses were localized in the brain stem, the thalamus, the corpuscallosum, the cerebral cortex or the subcortical area) and clinical influencingfactors (age, gender, GCS, BSR ete.) as independent variable and the progioseswere judged by Glasgow outcome scale6months after traumatic brain injury asdependent variable were recorded and analyzed by binary logistic regression, soas to determine the distribution of minimal hemorrhagic focuses in cranial CTscan can can become independent risk factors of poor prognosis and coma.2. Based on Logistic regression analysis, they were divided into four groups:interpeduncular cistern (IPC) blood group, midline brain areas hemorrhagegroup, both IPC blood and midline brain areas hemorrhage group, and controlgroup(both IPC blood and midline brain areas hemorrhage negative) accordingto CT scan if there is the following image, IPC blood, and midline brain areashemorrhage, and then, comparing the differences of Glasgow coma score(GCS),the persistent time of primary coma, Glasgow outcome score(GOS), between the groups above.Results1. Minimal hemorrhagic focus were localized in brain stem, interpeduncularcistern, the thalamus and the corpus callosum between the conscious or comagroups and favourable prognosis or poor prognosis were significantlydifferent.(The OR value of poor prognosis:9.725,8.355,3.729,4.348;The ORvalue of coma:4.493,3.565,3.140,2.869).The lesions of brain stem,the corpuscallosum and the thalamic by CT predict the poor outcomes andunconsciousness.2.These differences of parameters between the four groups above were staticallysignificant:IPC blood group,midline brain areas hemorrhage group, both IPCblood and midline brain areas hemorrhage group,and control group GCS(score)6[5-7]、7[6-8]、5[4-6]、9[9-10]; the persistent time of primarycoma(day)10.22±3.25、5.90±2.00、13.40±4.19、1.81±1.05； the poor rate oflong-term prognosis84.2%、61.90%、95.24%、23.33%. IPC blood and brainsteminjury is closely related: The evidence of IPC blood on CT scan as an indicatorof brainstem injury had a Kappa coefficient:0.819(95%CI:0.632,1), asensitivity of96.22%(95%CI:91.10%,100%), and a specificity of85.96%(95%CI:76.94%,94.98%), with a6.856likelihood ratio for a positive CT scan,and a0.0439likelihood ratio for a negative CT scan.ConclusionsThe CT manifestations can demonstrate the cerebral dysfunction andprobabilities of patients’ outcome.1.Minimal hemorrhagic focus were localized in brain stem, interpeduncularcistern,the thalamus and the corpus callosum are independent risk factors forDAI patients. 2. The finding of IPC blood on CT scan early after trauma in DAI patients is agood marker for brainstem injury.