磁敏感成像对急性脑梗塞并出血的诊疗价值  

The value of susceptibility-weighted imaging in diagnosis and treatment of acute cerebral infarction complicating brain bleeding

作　　者：沈比先[1] 谭四平[1] 李元歌[1] 谢景文[1] 毛文萍[1] 孙冰[1] 

机构地区：[1]广东医学院附属南山医院放射科,广东深圳518052

出　　处：《医学影像学杂志》2009年第8期956-958,共3页Journal of Medical Imaging

摘　　要：目的:探讨磁敏感加权成像技术(SWI)在急性脑梗塞合并脑出血的影像学特征,阐述SWI技术在急性脑梗塞的临床应用价值。方法:对48例急性脑梗塞患者进行CT、常规MRI、MRA、DWI、及SWI的自身对比研究。CT与磁共振检查间隔不超过12h,常规MRI、MRA、DWI、及SWI检查均同时进行。相关数据分析进行统计学处理。结果:48例脑梗塞中,SWI发现18例合并不同程度的脑出血,而CT、常规MRI、DWI均未见明确脑出血征象;DWI中有5例信号不均匀,结合SWI作回顾性分析考虑合并出血可能。CT显示脑梗塞34例;常规MRI显示40例;DWI显示48例;SWI显示39例,且病灶范围较DWI小,边缘模糊。SWI显示38例梗死区静脉血管减少;6例无变化;4例增多。13例MRA表现为大脑前、中、后动脉不同程度狭窄、闭塞或分支血管减少。结论:SWI技术对显示脑梗塞合并脑出血有特异性表现,且有评价梗塞区脑组织存活性的潜在价值,对指导临床治疗脑梗塞有着重大意义,应列为诊断急性脑梗塞的检查常规。Objective：To investigate the imaging feature of susceptibility-weighted imaging（SWI） in acute cerebral infarction（ACI） complicating brain bleeding, and to elaborate the clinical applications of SWI in ACI.Methods：48 cases of patients with ACI were performed with computer tomography（CT）, and within 12 hours conventional MRI, magnetic resonance angiography（MRA）, diffusion weighted imaging（DWI） and susceptibility-weighted imaging（SWI） were performed simultaneously. The related data were analyzed by statistics. Results： 18 in 48 cases with ACI complicated brain bleeding showed by SWI, while no definite brain bleeding showed by cr, conventional MRI and DWI. Inhomogeneous signal showed by DWI, which refer to SWI, were thought to be brain bleeding in 5 cases. CT showed ACI in 34 cases; Conventional MRI showed in 40; DWI showed in 48; SWI showed in 39, and the size of focus was smaller than DWI, the fringe of focus unclear. Veins in the area of infarction showed by SWI reduced in 38 cases, increased in 4 and normal in 6. MRA manifested the stenosis, obliteration or reduction in branch of anterior cerebral artery, middle cerebral artery and posterior cerebral artery in 13 cases. Conclusion： SWI can manifest the specificity in ACI complicating brain bleeding, and can be used to estimate the activity of brain tissue of infarction zone, which significantly influence the decision for clinic treatment. SWI should be used to be a routine examination for the diagnosis of ACI.

关 键 词：脑梗塞 脑出血 磁共振成像 磁敏感加权成像 

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]