摘要
目的 探讨脑梗死与脑出血急性 期应用磁共振弥散加权成像(DWI)联合磁 敏感加权成像(SWI)诊断的临床价值。方 法 选取2014年5月-2015年5月我院收治的 60例急性脑梗死患者(A组)和24例急性脑 出血患者(B组)为研究对象,所有患者均 行1.5T磁共振DWI和SWI序列检查,观察两 组患者的检查结果,并与12例正常自愿者 (对照组)作比较。结果 A组急性期DWI信 号较高,且随着时间的推移,信号增强越 明显,病灶边界由模糊转为清晰,阳性率 为100.0%,且SWI呈等信号;B组急性期 DWI血肿中心信号为低信号,周围呈高信 号,且随着时间的推移信号增强,SWI为 均匀低信号。与对照组相比,A组ADC值降 低,但降低幅度不大,且随着时间推移逐 渐下降,B组ADC值明显降低,但随着时间 的推移无明显改变,且B组ADC值下降幅度 大于A组,P<0.05;A组PV值正常,但出 血性转化时,局部PV值降低,B组PV值明 显降低,且B组PV值下降幅度大于A组,P <0.05。结论 脑梗死与脑出血急性期DWI 和SWI检查的影像学表现不同,而DWI联合 SWI应用于急性脑血管疾病的检查中,可 提高诊断的准确率,有助于及时检测出脑 梗死后出血性转化,对临床治疗具有重要 价值。
Objective To explore clinical value of magnetic resonance diffusion weighted imaging (DWI) combined with magnetic sensitive weighted imaging (SWI) in the diagnosis of cerebral infarction and acute phase of cerebral hemorrhage. Methods Sixty patients with acute cerebral infarction (Group A) and 24 patients with acute cerebral hemorrhage (Group B) admitted by the Hospital from may, 2014 to may, 2015 were selected as research subjects, all patients underwent 1.5T magnetic resonance DWI and SWI sequence examinations, test results of patients in two groups were observed, and they were compared to those of 12 normal volunteers (control group). Results DWI signal of patients at acute stage in Group A was higher, and the signal intensified with the passage of time, borders of lesions converted from fuzziness to clearness, the positive rate was 100.0%, and SWI showed equisignal signs. Acute DWI hematoma center showed low signal in Group B, periphery took high signal, and the signal intensified with the passage of time, while SWI was uniform low signal. ADC value in Group A significantly decreased when compared to that of patients in the control group, but the decrease extent was not significant when compared to that of patients in the control group, and gradually decreased as the elapse of time, ADC value of patients in Group B significantly decreased, but no obvious change occurred with the passage of time, and the decrease degree of ADC value in Group B was significantly greater than that of patients in Group A(P <0.05). PV value of patients in Group A was normal, but local PV value decreased when hemorrhagic transformation occurred, and the decrease degree of PV value of patients in Group B significantly was greater than that of patients in Group A(P<0.05). Conclusion Imaging appearances of DWI and SWI examinations during cerebral infarction and acute phase of cerebral hemorrhage are different, and DWI combined SWI applied in acute cerebrovascular disease inspection can improve the diagnostic accuracy, contributes to timely detect hemorrhagic transformation after cerebral infarction, and delivers important value for clinical treatment.
【关键词】脑梗死;脑出血;磁敏感加权成像;弥散加权成像
【中图分类号】R722.15+1
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2017.01.007
前言
急性脑血管疾病主要包括脑梗死与脑出血,是神经科常见急症中 的一种。在短时间内对超早期脑梗死进行有效诊断,排除脑出血,以 争取6小时内的溶栓治疗时间,对恢复缺血性半暗带正常功能,改善预 后具有重要意义[1]。虽然在出血与缺血性脑血管疾病中,DWI和SWI具有 不同的影像学表现,但两者联合应用于急性脑血管疾病的检查中,能 否缩短确诊时间,提高诊断效率成为国内外研究人员所关注的问题。 此次研究以我院84例急性脑血管疾病患者为研究对象,采用1.5T磁共 振DWI与SWI检查,取得效果较理想,现报道如下。
中国CT和MRI杂志
第15卷, 第 1 期
2017年01月
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