MRI、DWI及SWI在腔隙性脑梗死患者脑微出血筛查中的应用  

Application of MRI, DWI and SWI in screening cerebral microbleeds in patients with lacunar infarction

作　　者：刘文涛 戴博 孟庆成[1] 黎海亮[1] 窦新民[1] Liu Wentao;Dai Bo;Meng Qingcheng;Li Hailiang;Dou Xinmin(Department of Radiology,Henan Cancer Hospital,Zhengzhou 450000,China;Department of Radiology,Henan Provincial People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省肿瘤医院放射科,郑州450000 [2]河南省人民医院放射科,郑州450000

出　　处：《中国实用医刊》2021年第9期13-16,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨磁共振成像(MRI)、扩散加权成像(DWI)及磁敏感加权成像(SWI)在腔隙性脑梗死(LI)患者脑微出血(CMBs)筛查中的应用价值。方法抽取河南省肿瘤医院2018年5月至2020年4月收治的95例高度疑似LI伴CMBs患者为研究对象,所有患者均接受MRI、DWI、SWI及数字减影脑血管造影(DSA)检查。将DSA检查结果作为"金标准",分析MRI、DWI、SWI检查在LI患者CMBs筛查中的应用价值。结果95例高度疑似LI伴CMBs患者经DSA检查,79例确诊伴CMBs,占83.16%。参照DSA检查结果,MRI、DWI、SWI检查对LI伴CMBs患者诊断符合率分别为83.16%、87.37%、92.63%,差异未见统计学意义(P>0.05)。MRI、DWI、SWI检查与DSA检查结果均有理想的一致性(Kappa值=0.477、0.590、0.743)。MRI、DWI、SWI检查灵敏度、准确度、特异度比较,差异未见统计学意义(P>0.05)。LI患者CMBs在MRI检查的T1加权成像序列可见梗死病灶内存在低信号或等信号类圆形阴影,T2加权成像检查可见稍低信号环形或类圆形阴影;DWI检查可见低信号点状阴影;SWI检查可见低信号条状、环形或点状阴影,阴影边缘清晰。结论MRI、DWI及SWI对LI患者CMBs发生情况均有一定筛查价值,在实际应用时可考虑结合三者表现进行判定,以提高疾病早期诊断准确率。Objective To investigate the application value of magnetic resonance imaging(MRI),diffusion weighted imaging(DWI)and susceptibility weighted imaging(SWI)in screening cerebral microbleeds(CMBs)in patients with lacunar infarction(LI).Methods A total of 95 patients with highly suspected LI complicated by CMBs treated in Henan Cancer Hospital from May 2018 to April 2020 were selected as the research objects.All patients received MRI,DWI,SWI,and digital subtraction cerebral angiography(DSA)examinations.Taking results of DSA examination as the"gold standard",the application value of MRI,DWI,SWI in screening CMBs in LI patients was analyzed.Results Among 95 patients with highly suspected LI complicated by CMBs,79 cases were diagnosed with CMBs by DSA examination,accounting for 83.16%.According to the results of DSA examination,the diagnostic coincidence rates of MRI,DWI,SWI examination for patients with LI complicated by CMBs were 83.16%,87.37%,and 92.63%,respectively;and the difference was not statistical significant(P>0.05).The results of MRI,DWI,SWI all had ideal consistency with DSA examination(Kappa value=0.477,0.590,0.743).There was no significant difference in sensitivity,accuracy,and specificity among MRI,DWI and SWI(P>0.05).In the T1-weighted imaging(T1WI)sequence of the MRI examination of the CMBs in patients with LI,it could be seen that there was a low signal or isosignal circular shadow in the infarct focus;T2-weighted imaging(T2WI)inspection showed slightly low-signal ring or similar circular shadows;DWI inspection showed low-signal dotted shadows;SWI inspection showed low-signal strip,ring or dot shadows with clear edges.Conclusions MRI,DWI and SWI has certain value in screening CMBs in patients with LI,in practical application.The performance of the three can be considered to determine their combination,in order to improve the accuracy of early diagnosis of the disease.

关 键 词：腔隙性脑梗死 脑微出血 磁共振成像 扩散加权成像 磁敏感加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.33[医药卫生—诊断学]