弥散加权像(DWI)和灌注加权像(PWI)在超急性期脑梗死血管内治疗中的应用价值  

Application Value of Diffusion Weighted Image(DWI) and Perfusion Weighted Image(PWI) in Endovascular Treatment of Hyperacute Cerebral Infarction

作　　者：吴永斌 WU Yong-bin(Department of Neurology,First People＇s Hospital of Shizuishan,Ningxia Medical College,Shizuishan,Ningxia,753200 China)

机构地区：[1]宁夏医学院附属石嘴山市第一人民医院神经内科,宁夏石嘴山753200

出　　处：《中外医疗》2018年第25期181-183,共3页China & Foreign Medical Treatment

基　　金：超急性期脑梗死血管内治疗中弥散加权像(DWI)和灌注加权像(PWI)的临床应用(XM2016147)

摘　　要：目的探讨弥散加权像(DWI)和灌注加权像(PWI)在超急性期脑梗死血管内治疗中的应用价值。方法方便选取2016年8月—2017年12月该院收治的67例脑梗死患者作为研究对象,所有患者在入院后均采用常规MRI与磁共振弥散加权像(DWI)及灌注加权成像(PWI)检查,对不同检查方式下检查结果的差异进行统计分析。结果 DWI及PWI检查结果与临床最终诊断结果对比差异无统计学意义(P>0.05);DWI及PWI对所有患者超急性期脑梗死病例检出率显著高于普通MRI(96.43%,100.00%vs 78.57%),差异有统计学意义(P<0.05);超急性期脑梗死相对弥散系数(r ADC)显著高于急性期、亚急性期及慢性期[(0.73±0.12)vs(0.57±0.11)、(0.78±0.13)、(1.79±0.88)],差异有统计学意义(P<0.05)。结论 DWI及PWI在超急性期大面积脑梗死老年患者临床诊断的应用效果显著优于普通MRI,该检查方式可在短时间内对患者病情发生及进展进行准确诊断,可为患者后静脉溶栓及血管内介入治疗提供参考,具有较高的临床应用价值。Objective To investigate the value of diffusion-weighted imaging （DWI） and perfusion-weighted imaging （PWI） in endovascular treatment of hyperacute cerebral infarction. Methods A total of 67 patients with cerebral infarction in the hospital from August 2016 to December 2017 were selected as subjects. All patients were examined by conventional MRI, diffusion-weighted imaging （DWI） and perfusion-weighted imaging （PWI） after admission. Differences in inspection results under different inspection methods were statistically analyzed. Results There was no statistical significance in the difference between the results of DWI and PWI examination and the final clinical diagnosis,the different was statistically significant （P〉0.05）. The detection rate of super-acute cerebral infarction in all patients was significantly higher on DWI and PWI than that on ordinary MRI （96.43%, 100.00% vs 78.57%）,（P〈0.05）; The relative diffusion coefficient （rADC） in hyperacute cerebral infarction was significantly higher than that in acute, subacute and chronic phases [（0.73±0.12） vs （0.57±0.11）, （0.78± 0.13）, （1.79±0.88）],the different was statistically significant （P〈0.05）. Conclusion The application of DWI and PWI in the clinical diagnosis of elderly patients with large-area cerebral infarction during superacute phase is significantly better than that of ordinary MRI. This examination can accurately diagnose the occurrence and progression of patients in a short period of time, and can be used to provide intravenous thrombolysis for patients. And intravascular interventional therapy provides a reference, has a high clinical value.

关 键 词：超急性期脑梗死 DWI PWI MRI r ADC 

分 类 号：R743.33[医药卫生—神经病学与精神病学]