磁共振扩散加权成像ADC值测定评价脑梗死灶及周围缺血改变  

作　　者：杨慧强 曹志坚[2] 岑林[2] 

机构地区：[1]浙江省义乌市中医院,322000 [2]浙江省中医院,310006

出　　处：《浙江临床医学》2017年第2期336-337,351,共3页Zhejiang Clinical Medical Journal

摘　　要：目的利用磁共振扩散加权成像测定脑梗死核心区及周围组织表观扩散系数（ADC）值，评价脑梗死灶转归及周围组织缺血改变。方法收集80例急性脑梗死患者作为观察对象，梗死24h内行MR检查，40例第3天行MR检查，梗死区域为基底节区18例，丘脑8例，侧脑室旁12例，额叶2例；40例第7天行MR检查，梗死区域为基底节区16例，丘脑8例，侧脑室旁11例，额叶3例，枕叶2例。测量首诊和复查的脑梗死患者病灶核心区及核心区周围2cm范围内和相应层面对侧镜像区ADC值，比较不同时间ADC4值变化；按解剖部位分为基底节区组、丘脑组和侧脑室旁组，比较各组间ADC值变化。结果80例急性脑梗死患者3d与7d复查组病灶核心区ADC值差值差异有统计学意义（P〈0．001）；病灶周围ADC值差异有统计学意义（P〈0．001），ADC值变化与梗死解剖位置差异无统计学意义（P〉0．05）。结论ADC值能动态定量反映梗死核心区缺血与坏死的转归及周围脑组织缺血改变，有助于梗死灶的预后评价及疗效观察。Objective To utilize diffusion weighted imaging to measure ADC values of cerebral infarction core and surrounding tissues, evaluate the outcome of cerebral infarction. Methods 80 cases of acute cerebral infarction patients were collected as the research object, MRI scans were performed at initial diagnosis in 24 hours, 40 cases were reviewed with MR scan after 3 days, and others cases were reviewed with MRI scans after 7days. ADC values of infarction core and the tissues to around the core within 2 cm in the initial diagnosis were measured and patients were reviewed, and then ADC values of the corresponding level to the side mirror area were measured. To compare ADC values changes of different time. According to the anatomical site, they were divided into basal ganglia, thalamus and lateral ventricle group and comparison between groups of ADC values change. Results 80 cases of acute cerebral infarction patients ADC values had significant difference in 3 days and 7 days when reviewing the lesion core, with statistical significance （ P〈0.001 ） . The ADC values was of great difference in surrounding tissues with statistical significance （ P〈0.001 ） . The ADC values change with infarction of anatomical differences had no statistical significance （ P〉0.05 ） . Conclusions ADC value can quantitative and dynamic reflect the outcome of Ischemia and necrosis in the infarction area and the surrounding tissues, Could help us to evaluation the infarcts prognosis and curative effect observation.

关 键 词：脑梗死 磁共振成像 扩散加权成像 ADC值 

分 类 号：R730.44[医药卫生—肿瘤]