DWI结合ADC图诊断急性脑梗死的价值  

Evalution of DWI Combined with ADC Mapping in the Diagnosis of Acute Cerebral Infarction

作　　者：邱乾德[1] 许加俊[1] 刘绪明[1] 吴海[1] 叶大春[1] 陈祈平[1] 何晓华[1] 

机构地区：[1]温州市第三人民医院影像科,浙江425000

出　　处：《放射学实践》2006年第2期126-129,共4页Radiologic Practice

摘　　要：目的：评价扩散加权成像（DWI）和表观扩散系数（ADC）图对急性期脑梗死诊断的准确性。方法：对临床上拟诊为急性脑梗死患者进行常规MR扫描及DWI检查。回顾性分析109例在T2WI、T1WI、DWI、ADC图上信号强度的变化。结果：发病3h内（9例）在T2WI上呈稍高信号1例，等信号8例，T1WI上均为等信号，DWI上均为高信号，ADC图上均为明显低信号。发病4～15h（56例）在T2WI、DWI上均为高到高信号，在T1WI、ADC图上均为低信号。发病16～21h（22例）在T2WI、DWI上均为高信号；在T1WI上20例为低信号，2例为等低信号；ADC图上19例为低信号，3例为等低信号。发病22h上（22例）在T2WI上均为稍高信号；DWI上19例为稍高信号，3例为等信号；T1WI上20例为稍低信号，2例为等低信号；ADC图上12例为稍低信号，7例为等信号，3例为等低信号。结论：DWI结合ADC图对急性期脑梗死的诊断具有高度准确性，但单独DWI图像不能完全鉴别急性或亚急性病灶，应与T2WI、ADC图结合才能判断不同时期脑梗死。Objective：To evaluate the accuracy of MR diffusion-weighted imaging （DWI） and apparent diffusion coefficients（ADC） mapping in the diagnosis of hyperacute and acute cerebral infarction. Methods. The conventional MRI and DWI and ADC were performed in 109 patients after cerebral infarction. T2WI,T2WI,DWI images and ADC mapping were analyzed. Results=After the onset,in the first 3h （9 cases） T2WI showed slightly higher signal intensiy（1 case）,iso-signal intensity （8 cases）,T1WI showed all iso signal intensity,DWI showed all high signal intensity,ADC showed all obvious low signal intensity. In 4～15 h （56 cases） T2WI and DWI showed all high to high signal intensity, T1WI and ADC mapping showed all low signal intensity. In 16～21 h （22 cases） T2WI and DWI showed all high signal intensity,T1WI showed low signal intensity （20 cases） and iso low signal intensity （2 cases）. ADC mapping showed low signal intensity （19 cases） and iso low signal intensity （3 cases）. In 22 h and longer T2WI showed all slightly higher signal intensity （22 cases）, DWI showed slightly higher signal intensity （19 cases） and iso-signal intensity （3 cases）,T2 WI showed slightly lower signal intensity （20 cases） and iso low signal intensity （2 cases） ,ADC mapping showed slightly low signal intensity （12 cases） ,iso signal （7 cases） and iso low signal （3 cases）. Conclusion： DWI combined with ADC is highly accurate in diagnosing acute cerebral infarction,but DWI alone cannot differeatiate acute from subacute lesions. DWI and T2WI combined with ADC values can identify different stages of cerebral infarction.

关 键 词：脑梗死 磁共振成像 急性病 

分 类 号：R743.33[医药卫生—神经病学与精神病学]