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论著-头颈部

MRI磁敏感加权成像(SWI)在脑出血中的应用价值分析

作者:刘春岭

所属单位:四川省江油市人民医院(四川 江油 621700)

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摘要

目的探讨MRI磁敏感加权成像 (SWI)在脑出血中的应用价值。方法 对32 例经CT确诊的脑出血患者分别进行MRI常 规序列及SWI扫描,并对各序列的出血灶 显示率、微出血灶的检出率和分布进行 评估。结果 在32例脑出血患者中,共发 现75处出血灶。常规MRI(T1WI和T2WI)、 Flair和SWI序列对脑出血患者检出的阳性 率分别为28.13%、65.63%和100%,而 对出血灶的检出率分别为30.67%、45.33% 和100%。SWI序列的阳性率和检出率均显 著高于MRI其他常规序列(均P<0.05)。13 例患者在SWI序列上发现微出血灶,其中 基底节25处,小脑5处,脑干5处,丘脑3 处,大脑皮质下3处。结论 SWI序列比常 规MRI序列对显示脑出血更敏感,有很好 的临床应用价值,且对临床治疗有重要指 导意义。

Objective To approach the applicate value of MRI susceptibility weighted imaging(SWI) on intracerebral hemorrhage(ICH). Methods Thirty-two ICH patients diagnosed by CT were examined by conventional MRI sequence and SWI scan. The display rate of lesion, distribution of cerebral microbleeds and volume of hemorrhage were evaluated according to those examinations. Results Seventy-five hemorrhagic focus were found out in 32 ICH patients. The positive rate of patients by MRI(TlWI and T2WI), Flair, SWI was 28.13%、65.63%、100%, respectively. And the relevance rate of ICH was 30.67%、45.33% and 100%.The positive rate and relevance rate by SWI was significantly higher than the other MR sequences(all P<0.05). The cerebral micmbleed lesions were found in 13 eases by SWI, and there were 25 cerebral micmbleeds in basal ganglia area, 5 in cerebella, 5 in brain stem, 3 in thalamus, 3 in cerebral codex. Conclusion SWI sequence is more sensitive than conventional MRI sequences to show intracerebral hemorrhage(ICH).There is great value for SWI in clinical application, and it is also a very important guide for clinical treatment.

【关键词】磁敏感加权成像;脑出血;微出血灶;应用价值

【中图分类号】R743.34

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2015.03.05

前言

脑出血(intracerebral hemorrhage,ICH)是指原发性非外伤性 脑实质内出血,是一种神经内科常见的危重疾病,其具有发病率高, 致残率高,死亡率高的特点[1]。磁敏感加权成像(susceptibility weighted imaging,SWI)是一种新的磁共振成像方法,它不同于以往 的质子密度、T1或T2加权成像,这种新的成像方法是以T2*序列为基 础,利用对顺磁性物质磁敏感性不同而成像的技术[2]。SWI通过后处 理技术将获得的磁矩数据和相位数据相结合,形成独特的增强对比图 像,充分显示组织之间内在的磁敏感特性差异,使其能显示常规MRI无 法显示的图像。本研究分析比较了32例脑出血患者的常规MRI和SWI资 料,探讨其在脑出血中的应用价值。现将结果总结报告如下: