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研究与分析脑出血中应用磁敏感加权成像诊断效果*

作者:刘 彬

所属单位:辽宁省铁岭市中心医院影像科(辽宁 铁岭 112001)

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摘要

目的探讨与分析脑出血中应用 磁敏感加权成像诊断效果。方法 选取本 院经病理证实为脑出血的78例患者进行研 究,其中单纯性脑出血者为39例,脑肿瘤 出血者为39例。对患者分别采用T1WI和 T2WI及MR、CE-MR、SWI序列进行检查。同 时统计与分析SWI对单纯性脑出血与脑肿 瘤出血的鉴别诊断情况。结果 经诊断发 现,(1)脑肿瘤出血者中,6例出血完全覆 盖肿瘤实质者并未见明显强化,33例可见 不同程度强化。采用SWI扫描,其中33例 患者病变周围或局部出现粗细不等和迂曲 低信号血管影像,6例患者未见血管低信 号。(2)单纯性脑出血者中,13例未见明 显强化,26例边缘可见轻度强化。采用 SWI扫描提示39例患者未见明显肿瘤血管 低信号。结论 采用SWI扫描联合增强扫描 及常规MR扫描可有效提高临床单纯性脑出 血与脑肿瘤出血的临床诊断及鉴别率。

Objective Susceptibility Weighted Imaging Diagnostic Discussion and Analysis of the effect of the application of cerebral hemorrhage. Methods Select the hospital confirmed by pathology study of 78 patients with cerebral hemorrhage, which were simple for 39 cases of cerebral hemorrhage, brain tumor hemorrhage of 39 cases. Patients were used T1WI and T2WI and MR, CE-MR, SWI sequence to be checked. While the differential diagnosis of Statistics and Analysis of simple SWI cerebral hemorrhage and brain tumor hemorrhage. Results After diagnosis found that (1) brain tumor hemorrhage, and six cases of bleeding tumor parenchyma were completely covered and no significant enhancement seen 33 cases of varying degrees of enhancement. Using SWI scan, 33 patients with lesions appear around or partial thickness ranging from low signal and tortuous vascular imaging, six cases of patients with no vascular low signal. (2) simple cerebral hemorrhage in 13 cases no obvious enhancement, 26 cases of mild visible edge enhancement. Using SWI scan showed that 39 patients had no obvious tumor vasculature low signal. Conclusion SWI scan using joint enhanced scan and conventional MR imaging can effectively improve the clinical Simple cerebral hemorrhage and clinical diagnosis and differential rates of brain tumor hemorrhage.

【关键词】脑出血;磁敏感加权成像;MR

【中图分类号】R722.15+1

【文献标识码】A

【DOI】 10.3969/j.issn.1672-5131.2015.02.02

前言

近年来,随着人们生活节奏不断加快,然人们发生心脑血管人数 也在不断增加。脑出血是一种发病快速的出血性脑血管疾病,少数患 者症状较轻而极易被忽视,进而为日后发病埋下隐患[1]。由于脑肿瘤 出血较大时极易掩盖肿瘤实质部分,进而难以与单纯性脑出血鉴别而 导致误诊,最终耽误治疗最佳时机。如临床采用影像学方法及早发现 和诊断及鉴别,并及时治疗可减少或预防脑出血发生,避免并发症发 生,提高患者生活质量。磁敏感加权成像(SWI)是一种利用组织磁敏感 性不同而成像的新的对比增强技术,其提供了T1WI和T2WI及扩散加权 成像以外的另一种对比度。这种技术对含铁血黄素沉着和钙等顺磁物 质十分敏感,进而可较好地将肿瘤组织病理成分显示出,对临床鉴别 单纯性脑出血与肿瘤出血提供一定参考价值,同时为临床治疗和预防 提供重要的影像学参考依据,报道如下。