磁敏感加权成像诊断急性脑梗死动脉血栓的临床应用价值  

Clinical application value of susceptibility weighted imaging in diagnosing arterial thrombosis in acute cerebral infarction

作　　者：张冰[1] 刘筠[2] 廉凯茜[3] 许亮[2] 郝彩仙[2] 董龙春 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市人民医院影像学部,天津300121 [3]天津市环湖医院影像科,天津300060

出　　处：《中国临床医学影像杂志》2017年第5期315-317,340,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨磁敏感加权成像(SWI)在诊断急性脑梗死责任动脉血栓、评估患者病情及预后的临床应用价值。材料与方法:32例急性脑梗死患者均在3.0T MR扫描仪上行常规MRI、DWI、MRA和SWI检查。采用SWI-mIP图观察颅内动脉血栓。将动脉血栓在SWI上的显示定义为血管磁敏感征(SVS)。运用统计学分别计算SVS与急性梗死灶面积、入院时临床NIHSS评分及近期预后的相关性。结果:32例急性脑梗死患者中16例显示SVS阳性,阳性率为50%。SVS与MRA显示的动脉病变区位置吻合,并主要发生在大脑中动脉近段。SVS阳性患者急性梗死灶面积大于SVS阴性患者,差异有统计学意义(P<0.05)。SVS的显示与患者入院时NIHSS评分、近期预后均有相关性(P<0.05)。结论:SWI能提供急性脑梗死灶的责任动脉血栓,为临床选择治疗方案、评估病情及预后提供客观的影像学证据,SWI可常规应用于急性脑梗死患者。Objective： To discuss the clinical application value of susceptibility weighted imaging（SWI） in diagnosing arterial thrombosis, evaluating the condition and prognosis of patients in acute cerebral infarction. Materials and Methods： Thirty- two cases of acute cerebral infarction were imaged with conventional MRI, DWI, MRA and SWI. All patients underwent MR imaging using 3.0T MRI system. Using SWI-mIP to display arterial thrombosis. Define susceptibility vessel sign（SVS） as an arterial thrombosis is positive on SWI. The relationship among SVS and infarction area, clinical scores and shot-term prognosis were calculated respectively. Result： in 32 cases, 16 cases showed SVS sign. The positive rate of SVS was 50%（16/32）, consisted with the lesions region of MRA and mainly occured in proximal of middle cerebral artery. The acute infarction area with SVS positive was greater than the SVS negative, there had statistically difference（P〈0.05）. SVS displayed on SWI was associated with NIHSS scores, shot-term prognosis（P〈0.05）. Conclusion： SWI is useful for assessment in arterial thrombosis, providing objective imaging evidences for the choice of clinical treatment and the evaluation condition and prognosis of patients in acute cerebral infarction. SWI can be used routinely in patients with acute cerebral infarction.

关 键 词：脑梗塞 血栓形成 磁共振成像 

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]