摘要
目的 探讨磁共振弥散加权成 像(DWI)技术和磁共振液体衰减反转恢 复序列(fluid attenuated inversion recovery,FLAIR)在早期诊断急性脑梗 塞中的临床应用价值分析。方法 选取 2014年1月-2015年8月我院因急性脑梗 塞进行磁共振DWI和FLAIR序列扫描检查 的患者86例,其中有16例属于超急性期 (<6h),有32例属于急性期(6-24h),有 38例属于亚急性期(24-72h),对比分析 DWI、FLAIR图像病灶显示范围、边界及 对比度。结果 ①DWI和FLAIR序列对病灶 的显示范围比常规T1WI、T2WI要大,DWI 和FLAIR序列对病灶的对比均优于常规 T1WI、T2WI,与FLAIR相比,DWI对病灶 的显示更清晰。②DWI中弥散全方向比单 方向显示病灶清晰度更高,且DWI的b值 越高,对病灶的显示越清晰。结论 DWI技 术对急性脑梗塞病变敏感性最高,结合 FLAIR技术可以准确判断超急性及急性期 脑梗死。DWI序列在诊断急性脑梗塞方面 有非常明显优势,能够早期发现24小时 内特别是能够发现6小时内超急性期脑梗 塞,为病人及时治疗及减少后遗症有非 常重要的临床意义。
Objective To investigate the diffusion weighted magnetic resonance imaging (DWI) technique and magnetic resonance imaging, fluid attenuated inversion recovery (fluid attenuated inversion recovery, FLAIR) in the analysis of acute cerebral infarction in the clinical value of early diagnosis. Methods From January 2014 to August 2015 in our hospital, 86 patients with acute cerebral infarction underwent magnetic resonance DWI and FLAIR scan, among them, 16 cases belonged to the super acute phase (<6h), 32 cases belonged to the acute stage (6~24h), and 38 cases belonged to subacute phase (24-72h), compared and analyze the range, boundary and contrast of lesions in DWI and FLAIR images. Results (1) the range of DWI and FLAIR sequences was larger than that of conventional T1WI and T2WI, and the contrast of DWI and FLAIR sequences was better than that of conventional T1WI and T2WI. Compared with FLAIR, DWI showed clearer lesions. (2)In DWI, the diffuse whole direction is clearer than the single direction display, and the higher the b value of DWI, the clearer the display of the lesion. Conclusion DWI technique is the most sensitive to acute cerebral infarction, and it can be used to determine the hyperacute and acute cerebral infarction by combining FLAIR technique. The DWI sequence has a clear advantage in the diagnosis of acute cerebral infarction, early release of 24 hours, especially in the 6 hours of hyperacute cerebral infarction, for patients with timely treatment and reduce sequelae, has a very important clinical significance.
【关键词】DWI;FLAIR;早期诊断;急 性脑梗塞
【中图分类号】R743.33
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2018.01.006
前言
急性脑梗塞是由于脑供血突然中断后而导致的脑组织坏死。急性 脑梗塞的影像学诊断包括头颅CT和头颅磁共振扫描以及脑血管造影。 CT扫描能明确脑组织梗死的部位、大小、脑水肿程度等,但是CT扫 描在发病24小时内不能发现病灶,而且对脑干、小脑的病灶显示不 良。磁共振扫描能弥补CT扫描的缺点和不足,尤其是磁共振成像能显 示较大的闭塞血管[1]。现今,MRI弥散加权成像(diffusion-weighted imaging,DWI)和液体衰减反转恢复(fluid-attenuated inversionrecovery,FLAIR)技术在临床应用不断完善和发展,从而将DWI和FLAIR 运用于脑梗塞超急性期显示梗塞灶的部位与范围已成为可能。为此, 本文使用磁共振DWI和FLAIR序列在早期诊断急性脑梗塞中进行临床应 用价值分析,其报道如下。
中国CT和MRI杂志
第16卷, 第 1 期
2018年01月
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