弥散加权MRI在超急性脑梗死诊断中的应用研究  

Application study of diffusion-weighted imaging MR in the diagnosis of hyperacute cerebral infarction

作　　者：董海波[1] 徐海东[2] 张玉琴[1] 俞伉[1] 任峰[1] 张信忠[1] 王毅力[1] 沈天真[3] 

机构地区：[1]浙江省宁波市医疗中心李惠利医院放射科,浙江宁波315041 [2]浙江省宁波市第二医院放射科,浙江宁波315001 [3]复旦大学华山医院放射科,上海200032

出　　处：《中国临床医学影像杂志》2005年第9期484-486,共3页Journal of China Clinic Medical Imaging

基　　金：宁波市医学科技计划项目(计划编号:2003003)

摘　　要：目的:评估弥散加权MRI(DWI)对超急性脑梗死诊断的准确价值。方法:对临床高度怀疑超急性脑梗死且发病在6h以内的患者行急诊MRI和DWI检查。分析DWI诊断和最终临床诊断的相符性,比较DWI和常规MRI对超急性脑梗死敏感性和特异性、表观弥散系数(ADC)的时间变化规律。结果:DWI诊断超急性脑梗死20例,与最终临床诊断均符合。DWI所见高信号区域在CTMRI随访中均有脑梗死灶。DWI诊断超急性脑梗死的敏感性和特异性均为100%,常规MRI的敏感性为20%,特异性为100%;超急性脑梗死DWI信号上升,ADC值下降(P<0.001)。结论:DWI可作为诊断超急性脑梗死的一项重要指标。Objective： To evaluate the accuracy of diffusion-weighted imaging（DWI） MR in the diagnosis of hyperacute cerebral infarction. Materials and Methods： Those patients with onset of stroke-like symptoms that suggested a diagnosis of hyperaeute cerebral infarction underwent conventional MRI and DWI within 6 hours. Analyses comprised the consistency of the initial DWI with the final clinical diagnosis, comparison of sensitivity and specificity of DWI with those of conventional MRI, to determine the time course of the apparent diffusion coefficient （ADC）. Results： DWI defined hyperaeute cerebral infarction in 20 patients, all of whom had a final diagnosis of acute stroke. The high signal showed on DWI was confirmed with CT/MRI follow-up. DWI had a sensitivity and a specificity of 100% in the diagnosis of hyperaeute cerebral infarction, and conventional MRI yielded a sensitivity and a specificity of 20% and 100% respectively. The signal of hyperaeute cerebral infarction exhibited increased on DWI and decreased on ADC map. Conclusion： DWI is a significant method in the diagnosis of hyperaeute cerebral infarction.

关 键 词：脑梗塞 磁共振成像 弥散 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]