磁共振平扫联合磁敏感加权成像对颅内微出血性疾病的诊断价值研究  

Study on the diagnostic value of MRI plain scan combined with SWI for intracranial micro hemorrhagic disease

作　　者：荆彦平[1] 范起立 骆宾[1] 裴晓红[1] 徐新峰[1] 姚立东 辛欣[1] 张焱[3] 程敬亮[3] Jing Yanping;Fan Qili;Luo Bin;Pei Xiaohong;Xu Xinfeng;Yao Lidong;Xin Xin;Zhang Yan;Cheng Jingliang(MR Department,the Affiliated Huanghe Sanmenxia Hospital of Henan University of Science and Technology,Sanmenxia 472000,China)

机构地区：[1]河南科技大学附属黄河三门峡医院磁共振科,472000 [2]河南省三门峡市中医院磁共振科 [3]郑州大学第一附属医院磁共振科

出　　处：《实用医学影像杂志》2018年第5期386-389,共4页Journal of Practical Medical Imaging

基　　金：中国电建集团水电十一局基金项目(2018013)

摘　　要：目的探讨颅内微出血性疾病的磁共振成像(MRI)平扫联合磁敏感加权成像(SWI)诊断价值及鉴别诊断。方法回顾性分析41例临床明确诊断的颅内微出血性疾病的MRI图像,并分析其影像特征。结果41例中,高血压多发脑微出血15例,T_1WI、T_2WI及T_2Flair未能明确显示微出血灶;SWI在基底节区及部分皮层下见多发低信号微出血。脑淀粉样血管病6例,MRI平扫序列皮层下未见明显异常信号;SWI皮层下区见多发低信号微小出血灶。出血性脑梗死2例,T_1WI为等、低信号,T_2WI为高信号,T_2Flair为高信号;SWI显示高信号病变内部见低信号;弥漫性轴索损伤14例,部分病变显示为T_1WI低信号,T_2WI为高信号,T_2Flair为高信号;SWI脑实质内见多发低信号,大部分胼胝体受累,显示病变数目明显多于平扫;海绵状血管瘤4例,T_1WI呈高或稍高信号,T_2WI显示较典型的"爆米花"样改变,T_2Flair中央部分信号混杂,周边为低信号环;SWI呈结节状混杂信号,边缘围绕低信号环。结论 MRI平扫联合SWI可明显提高颅内微出血性疾病诊断准确率,并可进行鉴别诊断及病因判断,从而指导临床治疗方案选择。Objective To explore the diagnostic value of MRI plain scan combined with SWl for intracranial micro hemorrhagic disease and differential. Methods Retrospective analysis of 41 cases of intracranial micro hemorrhagic disease image and characteristics,clinical diagnosis. Results Among 41 cases,15 patients with hypertensive cerebral micro hemorrhage,TlWI、 T2WI and T2 Flair not able to clearly show micro hemorrhage. In the basal ganglia and some subcortical areas, SWl can see multiple low signal microbleeds. There were 6 cases of cerebral amyloid angiopathy, and no obvious abnormal signals were seen in the MRI scan sequence. In the cortex area of the SWl, there was a small hemorrhage with low signa1. 2 cases of hemorrhagic cerebral infarction, T1WI equal or low signal, T2WO as high signal, T2flair as high signal;SWl shows low signal in high signal lesions internal;There were 14 cases of diffuse axonal injury, and some lesions were shown as T1W1 low signal, T2W1 was high signal, T2 Flair was high signal; SWl shows multiple and low signals in brain parenchyma,and most of the callosum was affected, indicating that the number of lesions was significantly higher than plain scan. In 4 cases of cavernous angioma, T1W1 showed a high or slightly higher signal, T2W1 showed a more typical ＂corn-like＂ change, T2 Flair central part of the signal was mixed, and the peripheral was low-signal ring; SWl was a nodular mixed signal with a low signal ring around the edge. Conclusion MRI plain scan combined with SWI can significantly improve the diagnostic accuracy of intracranial micro hemorrhagic disease, and can be used for differential diagnosis and judgment,so as to guide the selection of clinical treatment options.

关 键 词：脑出血 磁共振成像 磁敏感加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]