磁敏感加权成像在早期脑梗死临床应用中的效果评价  

Clinical application value of magnetic susceptibility-weighted imaging in early cerebral infarction

作　　者：骆孟[1] 顾艳[1] 张波[1] 张天成[1] 王宗盛[1] 

机构地区：[1]江苏省连云港市第一人民医院影像科,222002

出　　处：《淮海医药》2016年第3期261-263,266,共4页Journal of Huaihai Medicine

摘　　要：目的:评价3.0T场强磁敏感加权成像(SWI)在早期缺血性脑梗死的临床应用中的效果。方法:收集近1年因早期缺血性脑梗死(3 d以内)入院进行MRI检查的26例患者,行T1WI,T2WI,DWI,MRA平扫及SWI扫描。计算病灶与正常对照区的校正相位值(CP),评估SWI与其他序列在显示血管性病变细节的优越性。结果:26例患者中梗死面积在100 mm2以下7例,大于100 mm219例。病变区的矫正相位均值较对侧镜像区升高,两者之间差异具有统计学意义(P<0.05);26例脑梗死患者中有17例合并有微出血,其中发现梗死灶内微出血有7例,梗死灶外陈旧性微出血有10例。而常规T1WI,T2WI及DWI序列检出脑梗死灶内出血仅4例,SWI对梗死后微出血及陈旧性微出血的显示明显高于常规序列(15.4%)。结论:SWI在早期脑梗死病变区的矫正相位均值要高于对侧镜像区校正相位均值(P<0.05);SWI较MRI常规序列及CT检查能够更敏感的显示梗死后微出血灶及脑内陈旧性微出血灶,且SWI minp图像上可观察到血管内血栓形成,对于临床溶栓治疗和强烈抗凝药物的使用起到一定的指导作用。Objective： To investigate the clinical application value of 3. 0T magnetic susceptibility-weighted imaging（ SWI） in early cerebral ischemic stroke. Methods： 26 patients in our hospital with early cerebral infarction were given conventional MRI examination and underwent T1 WI,T2WI,DWI,MRA and SWI scanning. Results： Of the 26 cases,7 had the infarct size smaller than 100mm2and19 larger than 100 mm2. The mean phase correction value of the lesion area was higher than that of the contralateral mirror area. The difference was statistically significant（ P 0. 05）. 17 of the 26 cases developed micro hemorrhage. Of the 17 cases of micro hemorrhage,infarct micro hemorrhage occurred in 7 and old micro hemorrhage outside the infarct in 10. Compared with the conventional sequence of T1 WI,T2WI,and DWI,only 4 cases of infarct micro hemorrhage were detected. SWI was evidently superior to the conventional sequence in detecting infarct micro hemorrhage and old micro hemorrhage outside the infarct（ 15. 4%,4 /26）. Conclusion： The mean phase correction value of the early cerebral infarction by SWI is higher than that indicated in the contralateral mirror area（ P 0. 05）.SWI is more sensitive than the conventional sequence of MRI and CT in detecting infarct micro hemorrhage after infarction and old micro hemorrhage outside the infarct. It is of guidance significance in clinical thrombolytic treatment and application of anticoagulants.

关 键 词：脑梗死 急性缺血性 磁敏感加权成像 影像诊断 

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]