目的 旨在探讨腔隙性脑梗死在 CT与MRI检查中临床影像学表现及诊断价 值。方法 收集2017年9月至2018年12月我 院收治的74例腔隙性脑梗死的临床病例及 影像学资料进行回顾性分析，对比MSCT和 MRI检查对腔隙性脑梗死的检出率，总结 腔隙性脑梗死在不同检查方法中的影像学 图像表现。结果 MRI检查对患者腔隙性 脑梗死病灶总检出率为97.29%，MSCT检 查对患者腔隙性脑梗死病灶总检出率为 83.78%，MRI检查对患者腔隙性脑梗死病 灶总检出率明显高于MSCT，差异间均具有 统计学意义(χ2 =7.889，P<0.05)；发病 时间＜6h者，CT平扫无法清晰显示病灶， 仅少数患者脑回沟提示轻微变窄；发病时 间6-24h者，脑沟消失，脑沟有不同程度 的变浅，灰白质无清晰界限，未见明显占 位效应；发病时间＞24h者，出现大脑中 动脉高密度征，占位现象明显，脑回不对 称，中线结构出现改变，豆状核边缘模 糊，脑灰质密度相对下降，脑白质界面模 糊。腔隙性脑梗死T1WI序列中显示为边界 清晰的低信号灶，T2WI序列为高信号灶； FLAIR序列中，急性期为高信号灶，慢性 期中心囊便部分信号减低，周围为高信 号；DWI序列中，急性期或亚急性期为高 信号灶，增强模式中，急性晚期或亚急性 期可出现明显强化。结论 CT与MRI均可有 效显示不同时期腔隙性脑梗死的图像特 征，其中MRI对腔隙性脑梗死病灶检出率 优于CT检查，有利于清晰发现微小病灶。

Objective To investigate the clinical imaging features and diagnostic value of lacunar infarction in CT and MRI. Methods The clinical data and imaging data of 74 cases of lacunar infarction admitted to our hospital from September 2017 to December 2018 were retrospectively analyzed. The detection rates of lacunar infarction by MSCT and MRI were compared.To summarize the imaging features of lacunar infarction in different examinations. Results The total detection rate of lesion of lacunar infarction by MRI was 97.29%. The total detection rate of of lesion of lacunar infarction by MSCT was 83.78%.The total detection rate of MRI was significantly higher than that of MSCT. The difference was statistically significant (χ2 =7.889, P<0.05).For patients whose onset time was <6h, CT scan can not clearly show the lesion, only a small number of patients showed slight narrowing of cerebral sulcus. For patients whose onset time was 6-24h, the cerebral sulcus disappeared and had varying degrees of shallowness. There was no clear boundary between gray matter and no obvious mass effect. For patients whose onset time was >24h, there was sign of high density in middle cerebral artery and obvious occupying phenomenon, the gyrus was asymmetrical, the structure of midline changed, the edge of the lenticular nucleus was blurred, the density of the gray matter relatively decreased, and the interface of the white matter was blurred. The T1WI sequence of lacunar infarction showed a low-signal lesion with clear boundary, and the T2WI sequence showed highsignal lesion. In the FLAIR sequence, the acute phase showed a high-signal lesion, and the chronic phase showed reducing of signal in the center of sac and high signal around the sac.In the DWI sequence, the acute phase or the subacute phase showed high-signal lesion, and in the enhanced mode, the acute and late phase or subacute phase may showed significant enhancement. Conclusion Both CT and MRI can effectively display the image features of lacunar infarction in different periods. MRI has better detection rate of lacunar infarction than CT, which is beneficial to clearly identify tiny lesions.