目的探讨MRI不同扫描模式在诊 断急性期脑梗死合并脑微出血患者中的应 用价值。方法 以2016年1月-2018年1月本 院收治的60例急性期脑梗死患者为研究对 象，均行常规MRI、弥散加权成像(DWI)和 磁敏感加权成像(SWI)序列扫描，比较MRI 不同扫描模式在诊断急性期脑梗死合并脑 微出血患者中的应用价值。结果 急性期 脑梗死合并A型脑微出血在SWI序列上表现 为点状信号丢失、周围无水肿、无占位效 应，DWI呈低信号，T2WI、FLAIR呈稍低信 号，T1WI呈类圆形等或低信号影；急性 期脑梗死合并B型脑微出血SWI序列上呈小 片状不规则低信号，DWI呈多发点片状低 信号影或混杂信号影，T1WI呈等或偏高信 号，T2WI呈等或略低信号，FLAIR呈略低 信号；SWI对脑微出血检出率明显高于DWI 和MRI常规序列(χ2 =49.412、36.505，P ＜0.05)；急性期脑梗死合并脑微出血患 者MRI不同扫描方式(DWI序列和SWI序列) 影像学图像各具特征。结论 SWI诊断急性 期脑梗死合并脑微出血患者中的应用价值 较MRI常规序列和DWI序列更高，更具临床 推广应用优势。

Objective To investigate the value of different MRI scan patterns in the diagnosis of acute cerebral infarction with cerebral microbleeds. Methods A total of 60 patients with acute cerebral infarction treated in the hospital from January 2016 to January 2018 were enrolled in the study. All patients underwent conventional MRI, diffusion weighted imaging (DWI) and magnetic susceptibility weighted imaging (SWI) sequence scanning. The value of different MRI scan patterns in diagnosing acute cerebral infarction with cerebral microbleeds was compared. Results Patients with acute cerebral infarction and type A cerebral microbleeds mainly manifested as spot signal loss, non peripheral edema and non occupying effect on SWI sequence, low signal on DWI, slightly lower signals on T2WI and FLAIR, quasi-circular equal or low density shadow on T1WI. Acute cerebral infarction with type B cerebral microbleeds showed small patchy irregular low signal on SWI sequence, multiple spotted and patchy low signal or mixed signal shadow on DWI, equal or slightly higher signal on T1WI, equal or slightly lower signal on T2WI, and slightly lower signal on FLAIR. The detection rate of cerebral microbleeds by SWI was significantly higher than that by DWI or MRI routine sequence (χ2 = 49.412, 36.505, P<0.05). Images of different MRI scan patterns (DWI sequence and SWI sequence) for patients with acute cerebral infarction and cerebral microbleeds were characteristic. Conclusion The value of SWI in the diagnosis of acute cerebral infarction with cerebral microbleeds is higher than that of MRI routine sequence or DWI sequenc. It has more advantages in clinical application.