目的 分析急性期脑梗死患者 电子计算机断层扫描 ( c o m p u t e r i z e d tomography，CT)及磁共振成像(magnetic resonance imaging，MRI)的影像学特 点。方法 按纳入排除标准选取我院自 2016年1月-2018年4月收治的800例急性 期脑梗死患者为研究对象，其中288例自 发病至入院检查时间＜6h(超急性期)、 6-24h 240例(急性期)、1d-14d 272例(亚 急性期)；回顾性分析其CT、MRI影像学资 料及临床病历，比较CT、MRI对急性期脑 梗死的诊断价值，并分析其影像学特征。 结果 MRI在急性期脑梗死任意时段，脑梗 死检出率均显著高于CT(P＜0.05)；且超 急性期CT常无明显异常表现，急性期及亚 急性期可出现早期低密度影，皮质、白质 边界不清，豆状核和脑岛带征，脑沟回、 脑室及脑池改变，并在大血管闭塞后出现 大脑中动脉或基底动脉高密度征等影像表 现；超急性期MRI可见病变在弥散加权成 像(diffusion weighted image, DWI)上 呈明显高信号，但TIWI、T2WI、FLAIR均 无明显异常信号；急性期MRI亦可见DWI高 信号，且TIWI低信号，T2WI、FLAIR高信 号，T2WI、FLAIR信号强度弱于DWI；亚 急性MRI可见DWI高信号，TIWI低信号， T2WI、FLAIR高信号，且T2WI、FLAIR信号 强度较DWI信号强。结论 急性期脑梗死任 意时间段行CT及MRI均可为其临床诊治提 供更完整的影像学依据，值得临床重视。

Objective To analyze the features of computerized tomography (CT) and magnetic resonance imaging (MRI) in patients with acute cerebral infarction. Methods According to the inclusion exclusion criteria, 800 patients with acute cerebral infarction in our hospital from January 2016 to April 2018 were selected in the study. Among them, 288 patients with the time from onset to admission less than 6h (super acute phase), 240 cases (acute phase) with 6 to 24h, 272 cases (subacute phase) with 1d to 14d. The imaging data of CT, MRI and clinical medical records were analyzed retrospectively, the diagnostic value of CT and MRI in the acute cerebral infarction was compared, the imaging features were analyzed. Results In any time of the acute cerebral infarction, the detection rate of cerebral infarction with MRI was significantly higher than that with CT (P<0.05). There was no obvious abnormality in CT influences at super acute period, there were early low density imaging, obscure boundary of cortical and white matter, lenticular and insular symptoms, changes of sulcular gyrus, ventricle and cerebral cistern in acute phase and subacute phase, there were high-density signs of middle cerebral artery or basilar artery after large vessel occlusion. There was significantly high signal expression of diffuse weighted image (DWI) in hyperacute phase MRI, there were no obvious signal changes of TIWI, T2WI, FLAIR. There was DWI high signal at acute period with MRI and low signal of TIWI, T2WI, FLAIR were high signal, the signal intensity of T2WI and FLAIR was weaker than DWI. There were DWI high signal, TIWI low signal, T2WI and FLAIR high signal, stronger signal intensity of T2WI FLAIR than DWI in subacute period with MRI. Conclusion CT and MRI in patients with acute cerebral infarction at any time can provide a more complete imaging basis for clinical diagnosis and treatment, which deserves clinical attention.