腦外傷病人之磁振造影和運動功能之關係

The Relationship Between Magnetic Resonance Inaging and Motor Outcome Following Traumatic Brain Injury

鍾進燈(Chinn-Dong Chung) ； 蘭西史東(Lance R. Stone) ； 安琪拉王(Angela Wang) ； 黃強(Jang Huang)

《中華民國復健醫學會雜誌》 21期 (1993/12) Pp. 87-94

摘要

腦部傷害是一種常見意外傷害，而且病例愈來愈多，病人常留下許多後遺症，運動障礙是常見而且嚴重之一。
Wilson等人，曾以CT研究腦傷病人，發現傷害部位愈深，意識狀態恢復，神經心理測驗結果愈差，其結果和Mmaya等人動物實驗結果一致，即傷害部位愈深愈嚴重，但是在運動功能恢復後評估上，是否如此，尚無人研究。
磁振造影（MRI）目前已普遍用於腦外傷害病人，它的顯像效果優於大腦斷層攝影（CT），能夠偵測較深，較小，甚至續發性腦組織傷害病灶。
醫師是否能夠以早期之磁振造影，來預測病人未來運動功能之恢復情況呢？
以34位成年腦傷住院病人做為研究對象，每個病人均行磁振造影，經復健治療6個月後再做運動功能評估，其結果是否和Wilson等人一致呢？
放射科醫師依腦部病灶位實深度差異分類成四級，作者以Revised Fugl Meyer法評估運動功能，利用電腦分析研究二者之間之關係。
結果顯示運動功能障礙與腦部傷害深度無關，但是顯示出無腦實質病灶，無腦室擴大者較有腦實質病灶，腦室擴大者為佳，碰振造影雖可提供較佳診斷，但在運動功能預後上并無超越腦部斷層攝影。

並列摘要

Thirty four adults with traumatic brain injury [TBI] who had magnetic resonance imaging [MRI] within three months were evaluated motor outcome 6 to 18 months after injury. MRI were classified into four groups according to the depth of abnormality detected and the motor function evaluated with revised Fugl-Meyer method. The results showed no positive relationship between motor outcome and the depth of lesion detected by MRI. It was different from the result of Wilson's studies which had positive finding between the depth of brain lesions detected by MRI and
neuropsychological outcome. Better prognosis was found in nonparenchymal abnormality or no ventricular enlargement and worse prognosis in parenchymal abnormality or ventricular enlargement consistent with atrophy detected by MRI. Although MRI can show deeper and smaller detail of traumatic brain lesions, it is not much better than CT scan as far as prognosis prediction of motor function is concerned.

並列關鍵字

TBI ； MRI ； Motor outcome