急性缺血性脑卒中CT、MRI诊断价值  

Diagnostic value of CT and MRI in acute ischemic stroke

作　　者：许开喜[1] 丰广魁[2] 陈新建[1] 左涛生[1] 王金[1] 孟云[1] 胡方云[1] 徐敏[1] 马先军[2] 卞光荣[2] XU Kaixi1,FENG Guangkui2,CHEN Xinjian1,ZUO Taosheng1,WANG Jin1, MENG Yun1,HU Fangyun1,XU Min1,MA Xianjun2,BIAN Guangrong2(1 Department of Radiology ;2 Department of Neurology,Lianyungang Hospital,Lianyungang TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Lianyungang 222004,Chin)

机构地区：[1]连云港市中医院南京中医药大学连云港附属医院影像科,江苏连云港222004 [2]连云港市中医院南京中医药大学连云港附属医院神经内科,江苏连云港222004

出　　处：《实用放射学杂志》2018年第3期339-343,共5页Journal of Practical Radiology

摘　　要：目的 探讨多排螺旋CT、3.0T MR的液体衰减反转恢复成像序列（FLAIR）、磁共振血管成像（MRA）与磁敏感加权成像（SWI）对急性缺血性脑卒中（AIS）的诊断价值。方法 48例AIS（〈72 h）均行常规CT、MRI、MRA及SWI检查患者，利用CT、FLAIR与SWI联合应用对AIS的大脑中动脉高密度征（HMCAS）、近端高信号血管征（HVS）与血管磁敏感征（SVS）和大脑中动脉点征（DMCAS）、远端HVS与病灶周围软脑膜血管的侧支循环血管扩张程度相关性分析。结果 在48例AIS中大脑中动脉（MCA）中HMCAS、DMCAS、近端HVS、远端HVS、SVS和病灶周围软脑膜血管与同镜像区扩张阳性分别18例、12例、33例、40例、43例和39例，分别占总数37.5%、25.0%、68.7%、83.3%、89.6%和 81.2%；SVS与HVS责任血管相关性分析,差异有统计学意义（P〈0.05）；MCA近端的HVS与HMCAS 责任血管相关性分析，差异有统计学意义（P〈0.01）。病灶周围有、无软脑膜血管与远端HVS显示程度相关性分析, 两者责任血管具有高度一致性（P=0.789）。MCA远端HVS与DMCAS显示程度相关性分析，差异有统计学意义（P〈0.01）。结论 MCA的SVS、近端HVS和HMCAS对AIS的责任血管具有明显一致性，SWI显示病变责任动脉优于FLAIR及CT，DMCAS、远端HVS和病灶周围软脑膜血管扩张具有高度一致性。Objective To explore the diagnostic value of helical CT, fluid attenuated inversion recovery （FLAIR） ,magnetic resonance angiography （MRA） and susceptibility weighted imaging （SWI） at 3.0T MR for acute ischemic stroke （AIS）.Methods 48 cases of AIS（（72 h） underwent conventional CT, MRI, MRA and SWI. The correlations between hyperdense middle cerebral artery sign （HMCAS）, proximal hyperintense vessel sign（HVS）, magnetic sensitive spatially-integrated susceptibility vessel sign（SVS） ,vascular dot middle cerebral artery sign （DMCAS） ,distal HVS and collateral circulation of the blood vessels surrounding leptomeninges expansion degree were analyzed.Results In 48 AIS cases, HMCAS were showed in 18 （ 37.50/60 ）, DMCAS 12 （ 25.0% ）, proximal HVS 33 （ 68.7% ）, distal HVS 40（83.3%）, SVS 43 （89.6%） and surrounding soft meningeal vascular 39 （81.2%）.The difference between spatially-integrated SVS and HVS was statistically significant （P〈0.05） ;For HVS and HMCAS responsibility blood vessels at the bottom,the difference was statistically significant （P〈0.01）.For pia mater lesions around the blood vessel and distal HVS display degree, the responsibility of the blood vessels was high consistency （P =0.789）.The difference between MCA distal HVS and DMCAS was statistically significant （P^0.01）.Conelusion It has obvious consistency for SVS, proximal HVS and HMCAS of MCA on the responsibility of AIS. SWI is better than FLAIR and CT.It has obvious statistical sighificance between DMCAS, HVS and surrounding leptomenings vasodilatiov.

关 键 词：大脑中动脉血管征 急性缺血性脑卒中 计算机体层成像 磁共振成像 

分 类 号：R743[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]