DWI在MCA区急性脑梗死患者诊断中的应用价值  

The value of DWI in the diagnosis of acute cerebral infarction in MCA area

作　　者：陈庆华[1] 王向明[1] 方权[1] 李彦君[1] 王振强[1] CHEN Qinghua;WANG Xiangming;FANG Quan;LI Yanjun;WANG Zhenqiang(Department of Radiology,Yiwu Central Hospital,Yiwu 322000,P.R.China)

机构地区：[1]浙江省义乌市中心医院放射科

出　　处：《医学影像学杂志》2019年第12期2015-2018,共4页Journal of Medical Imaging

基　　金：浙江省义乌市科技局财政专项扶持资金竟争性分配项目(编号:2016-S-02)

摘　　要：目的探究弥散加权成像(DWI)在大脑中动脉(MCA)供血区急性脑梗死诊断中的应用价值。方法选择2016年12月~2018年12月在我院治疗的121例急性脑梗死患者作为观察对象,对所有患者进行常规MRI检查、DWI检查和磁共振血管成像(MRA)检查,观察、分析其影像学资料,并对其脑梗死区体积和脑动脉狭窄程度进行计算。结果121例的DWI结果均能够清晰显示神经体征对应区域的梗死病灶,DWI对病灶的显示范围、对比程度均明显优于T 1WI、T 2WI。超急性脑梗死、急性脑梗死患者的患侧ADC值均明显低于健侧ADC值,超急性脑梗死患者的rADC值为60.23%,明显高于急性脑梗死(50.12%),差异比较有统计学意义(P<0.05)。MRA结果显示,11例表现正常,62例MCA区主支血管影及其分支缺失,22例MCA区血管影呈现局限性狭窄、稀疏,26例的MCA区主支血管影粗细不均及狭窄,分支血管影表现为弥漫性稀疏,呈枯枝状。MCA区狭窄越严重的患者,其DWI异常区体积越大,不同MCA区域狭窄程度患者的DWI异常区体积上比较存在显著差异(P<0.05)。结论DWI在诊断MCA区急性脑梗死敏感性和特异性较高,可在发病早期快速定位病灶,在显示病灶上优于常规MRI扫描。MCA区急性脑梗死患者DWI异常区体积与其MCA区血管狭窄程度有关,可将其作为预测病程严重程度的临床指标。Objective To research the value of diffusion weighted imaging(DWI)in the diagnosis of acute cerebral infarction in middle cerebral artery(MCA)blood supply area.Methods 121 patients with acute cerebral infarction admitted to our hospital from December 2016 to December 2018 were selected as the research objects.All patients were examined by routine MRI,DWI and magnetic resonance angiography(MRA).The imaging data of all patients were analyzed,and the volume of cerebral infarction area and the degree of arterial stenosis were calculated.Results The results of DWI in 121 patients could clearly show the infarct lesions in the corresponding areas of nerve signs.The demonstration scope and contrast degree of DWI for the lesions were significantly better than those of T 1WI and T 2WI.The ADC values of patients with hyperacute cerebral infarction and acute cerebral infarction on the affected side were significantly lower than those of the healthy side.The rADC value of patients with hyperacute cerebral infarction was 60.23%,significantly higher than those of patients with acute cerebral infarction(50.12%).The difference was statistically significant(P<0.05).The results of MRA showed that 11 cases were normal,62 cases were absent of main vessel shadow and its branches in MCA area,22 cases had limited stenosis and sparsity in MCA area,26 cases showed diffuse sparse and withered branches in MCA area,and often accompanied by uneven thickness and stenosis of main vessel shadow in MCA area.The more severe the stenosis of MCA area,the larger the abnormal volume of DWI area.There were significant differences in the abnormal volume of DWI area between patients with different stenosis degree of MCA area(P<0.05).Conclusion DWI has high sensitivity and specificity in the diagnosis of acute cerebral infarction in MCA area.It can quickly locate the lesion in the early stage of onset and is superior to conventional MRI in displaying the lesion.The abnormal volume of DWI in patients with acute cerebral infarction in MCA area is related to

关 键 词：急性脑梗死 大脑中动脉供血区 磁共振成像 弥散加权成像 

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]