磁共振梯度回波T2*加权像对蛛网膜下腔出血合并侧脑室后角内积血的诊断及其临床意义  

Diagnosis and clinical significance of gradient echo T2 * weighted image of magnetic resonance to subarachnoid hemorrhage with hematocele of cornu occipital

作　　者：刘绥杰[1] 宋磊[1] 刘国荣[1] 李月春[1] 王宝军[1] 

机构地区：[1]包头市中心医院神经内科,内蒙古014040

出　　处：《中华脑科疾病与康复杂志（电子版）》2014年第2期22-25,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：内蒙古卫生厅科技计划项目(20061108)

摘　　要：目的探讨磁共振梯度回波T2*加权成像(GRE-T2*WI)序列对蛛网膜下腔出血(SAH)合并侧脑室后角内积血的诊断及其临床意义。方法对50例临床上经症状、体征、CT或腰椎穿刺确诊为SAH的患者进行研究,将50例SAH患者根据头颅MRI检查距发病的时间分为急性期SAH组(≤4 d),亚急性、慢性期SAH组(>4 d),分析急性期和亚急性、慢性期SAH组患者合并侧脑室后角内积血的比例,探讨磁共振GRE-T2*WI序列对SAH合并侧脑室后角内积血的诊断价值及其临床意义。结果 (1)急性期SAH组:26例急性期SAH患者磁共振GRE-T2*WI序列均发现侧脑室后角内积血,比例为100%;(2)亚急性、慢性期SAH组:24例亚急性、慢性期SAH患者磁共振GRET2*WI序列发现侧脑室后角内积血21例,比例达87.5%;(3)磁共振GRE-T2*WI序列上侧脑室后角内积血表现为侧脑室后角内环行低信号影伴液平,与侧脑室内脑脊液高信号影形成鲜明对比,显示清晰,易于辨认,且极少量侧脑室后角内积血也能清晰显影。因蛛网膜下腔狭小,分布范围广,脑脊液循环流动,有血管影干扰等特点,在MRI诊断SAH阅片过程中存在一定难度,发现GRE-T2*WI序列侧脑室后角内积血,除外脑室出血破入蛛网膜下腔和原发脑室出血,提示SAH。结论 (1)SAH合并侧脑室后角内积血在SAH的急性期、亚急性慢性期均有很高的比例;(2)磁共振GRE-T2*WI序列上对侧脑室后角内积血显示清晰、易于辨认,磁共振GRE-T2*WI序列诊断侧脑室后角内积血除外脑出血破入蛛网膜下腔、原发脑室出血提示有SAH。Objective To approach the diagnosis and clinical significance of gradient echo T2 ＊ weighted image of magnetic resonance to subarachnoid hemorrhage with hematocele of cornu oocipitale. Methods Fifty patients who were finally diagnosed as subarachnoid hemorrhage （SAH）according to symptoms,physical signs, CT or lumbar puncture entered the study. All cases were divided into acute SAH group（ ≤4 d）and subacute and chronic SAH group（ 〉4 d） according to the interval time from the ictus to MR/scan. Analyze the rates of subarachnoid hemorrhage with hematocele of cornu occipital in the acute SAH group and in the subacute and chronic SAH group, and approach the diagnosis and clinical significance of gradient echo T2 ＊ weighted image of magnetic resonance to subarachnoid hemorrhage with hematocele of cornu occipitale. Results （ 1 ） Acute SAH group： all twenty-six cases were detected with hematocele of cornu occipitale. The rates of subarachnoid hemorrhage with hematocele of comu occipital in the acute SAH group were all to 100% ;（2）Subacute and chronic SAH group：twenty-one cases of twenty-four cases were detected with hematocele of comu occipitale. The detection rate of CT was 87. 5% ;（ 3 ）Hematocele of cornu occipital in the gradient echo T2 ＊ weighted image manifest ring-shaped hypointensity with fluid level, comparisoned brightly with the hyperintense of cerebrospinal fluid in comu occipital. It was manifested clearly and identified facilely, moreover the thimbleful hematocele of cornu occipital was manifested clearly. With the features of narrow subarachnoid space, extensive distribution range, cerebrospinal fluid circulating flow and blood vessels imaging disturbance, there was the difficulty in the process of the reading slices of MRI in diagnosing subarachnoid hemorrhage. To detect the hematocele of cornu occipitale in gradient echo T2 ＊ weighted image hint subarachnoid hemorrhage,except the cerebral hemorrhage to break into subarachnoid hemorrhage and the constitutional cerebro

关 键 词：磁共振波谱学 蛛网膜下腔出血 诊断 梯度回波T2＊加权像 侧脑室后角 内积血 

分 类 号：R743.35[医药卫生—神经病学与精神病学]