磁共振DWI和PWI在超急性脑梗死诊治中的应用  

Application of MR DWI and PWI for emergent diagnosis and therapy of hyperacute cerebral infarction

作　　者：祁建军[1] 栾阳[1] 高向东[1] 苏晋生[1] 

机构地区：[1]山西省太原市中心医院影像科,山西太原030009

出　　处：《实用医学影像杂志》2012年第2期69-71,共3页Journal of Practical Medical Imaging

摘　　要：目的评价磁共振弥散加权成像(DWI)和灌注加权成像(PWI)在超急性脑梗死诊断及指导临床早期溶栓治疗中的应用价值。方法 56例发病在6 h以内且临床提示处于超急性期脑梗死患者均行急诊MRI检查,扫描序列包括T1WI、T2WI、FLAIR、DWI及PWI,部分病例行MRA检查。结果 56例患者T1WI均未见异常信号,35例患者T2WI、FLAIR发现有轻微异常信号影。56例DWI和PWI均发现异常,但在DWI上显示的高信号急性脑梗死区域与在PWI上显示的脑灌注延长区域不匹配,PWI显示的病灶范围更大。图像后处理显示平均通过时间(MTT)、达峰时间(TTP)均有不同程度的延长,脑血流量(CBF)出现不同程度的减少。结论急诊MRI,特别是DWI和PWI序列对超急性脑梗死患者可以作出准确的诊断,可以安全、迅速、有效地指导临床进行早期溶栓治疗。Objective To assess the applied value of MR diffusion weighted imaging（DWI） and perfusion weighted imaging（PWI） for emergent diagnosis of hyperacute cerebral infarction（HACI） and guiding its thrombolytic therapy.Methods 56 cases with HACI suspected clinically underwent emergent MR scanning within 6h after onset.The scanning sequences included T1WI,T2WI,fluid attenuation inversion recovery（FLAIR）,DWI and PWI.Some patients underwent additional MR angiography（MRA）.Results No abnormal signals appeared in 56 cases on T1WI,slightly abnormal signals appeared in 35 cases on T2WI and FLAIR.The abnormal signs could be found both on DWI and PWI,but the acute cerebral infarction regions of hyper intensity seen on DWI mismatched the prolonged cerebral perfusion regions visualized by PWI,the affected region was more broader on PWI.Both mean transit time（MTT） and time to peak（TTP） prolonged according to the post processed images.Cerebral blood flow（CBF） was reduced.Conclusion Emergent MRI,especially DWI and PWI can be significant to diagnosis of hyperacute cerebral infarction,it can be a safe,quick and effective mean for guide clinically thrombolytic therapy of HACI.

关 键 词：脑梗死 超急性 弥散加权成像 灌注加权成像 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]