急性脑梗死MRI弥散加权成像持续阴性的探讨（附2例报告）  

Sustained diffusion-negative MRI in acute cerebral infarction（ two cases report）

作　　者：石蕾[1] 段磊[1] 

机构地区：[1]复旦大学附属上海市第五人民医院神经内科,200240

出　　处：《临床内科杂志》2012年第7期466-468,共3页Journal of Clinical Internal Medicine

摘　　要：目的分析急性脑梗死MRI弥散加权成像（DWI）持续阴性患者的临床特点和影像学表现，提高诊断正确率。方法对2例临床诊断为急性脑干梗死，但DWI表现持续阴性的患者，按急性脑梗死方案予以降低纤维蛋白原水平、抗血小板聚集、抗凝、功能锻炼等治疗，并对其临床特点、辅助检查及治疗效果进行分析，结合相关文献，探讨DWI弥散加权成像特点，分析持续阴性的原因并进一步探讨DWI持续阴性的分子机制。结果2例DWI持续阴性患者，临床症状较重，经过早期干预治疗症状均好转。结论临床上存在DWI阴性的急性脑梗死，应结合临床症状，提高对此类患者的认识，对开展时间窗内溶栓治疗，减少致死率、致残率具有重要意义。Objective To improve the accuracy of diagnosis, we investigate the MRI diffusion weighted Imaging（ DWI）-negative clinical features and imaging findings. Methods Our diagnosis for 2 cases on the basis of clinical symptoms of acute brain stem infarction, DWI-negative patients, treatment of acute cerebral infarction after thrombolytic therapy to poly, anticoagulation and functional exercise for treatment. By analysing clinical features, auxiliary examination and retrospective analysis of the treatment effect, combining with the relevant literature, exploring DWI diffusion-weighted imaging features, we analy- ses the causes of sustained negative of DWI and further discussion on the molecular mechanisms. Result With negative of DWI but clinical symptoms more severe, nevertheless improved prognosis after early inter- vention treatment, reduces disability rates, improve patients＇ quality of life. Conclusion Clinically, there was negative DWI in acute cerebral infarction, raise awareness of the acute cerebral infarction, thrombolyt- ic treatment within a time window, reduce mortality rates, disability rates is of great significance.

关 键 词：脑梗死 核磁共振 弥散加权成像 

分 类 号：R74[医药卫生—神经病学与精神病学]