常规轴位和薄层矢状位弥散加权成像联合应用改善急性脑干梗死检测能力  

Combination of conventional axial and thin-layer sagittal diffusion-weighted imaging to improve the detection ability of acute brainstem infarction

作　　者：王黎明[1] 侯会敏 于进超 李梦凡 Wang Liming;Hou Huimin;Yu Jinchao;Li Mengfan(Department of Imaging,Weihai Municipal Hospital,Shandong University,Weihai 264200,China;Department of Neurology,Weihai Municipal Hospital,Shandong University,Weihai 264200,China)

机构地区：[1]山东大学附属威海市立医院影像科,威海264200 [2]山东大学附属威海市立医院神经内科,威海264200

出　　处：《国际脑血管病杂志》2021年第5期337-341,共5页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨常规轴位和薄层矢状位弥散加权成像(diffusion-weighted imaging,DWI)联合应用能否改善急性脑干梗死(acute brainstem infarction,ABI)的检测能力。方法回顾性纳入2019年1月至2020年7月期间山东大学附属威海市立医院收治的临床诊断为ABI患者。所有患者在入院后均行常规轴位及薄层矢状位DWI检查,无法明确诊断者在出院前再次进行DWI复查证实。记录仅常规轴位和常规轴位+薄层矢状位DWI检测不同部位脑干梗死的阳性病例数及阴性病例数。结果共纳入65例ABI患者。仅常规轴位DWI阳性51例(78.5%),阴性14例(21.5%);常规轴位+薄层矢状位DWI阳性60例(92.3%),阴性5例(7.7%)。其中,8例延髓梗死仅常规轴位DWI阳性4例(50.0%),常规轴位+薄层矢状位DWI阳性6例(75.0%);50例脑桥梗死仅常规轴位DWI阳性44例(88.0%),常规轴位+薄层矢状位DWI阳性48例(96.0%);4例中脑梗死仅常规轴位DWI阳性1例(25.0%),常规轴位+薄层矢状位DWI阳性3例(75.0%);3例脑桥+中脑梗死仅常规轴位DWI阳性2例(66.7%),常规轴位+薄层矢状位DWI阳性3例(100.0%)。轴位联合薄层矢状位DWI对ABI的检出率显著高于单纯常规轴位DWI,差异有统计学意义(92.3%对78.5%;χ2=4.993,P=0.026)。结论联合应用常规轴位和薄层矢状位DWI能提高ABI的检出率。对于轴位DWI未发现病灶或诊断不明确的ABI患者,应加用薄层矢状位DWI。Objective To investigate whether the combination of conventional axial and thin-layer sagittal diffusion-weighted imaging(DWI)can improve the detection ability of acute brainstem infarction(ABI).Methods Patients with ABI diagnosed clinically and admitted to Weihai Municipal Hospital,Shandong University from January 2019 to July 2020 were enrolled retrospectively.All patients underwent conventional axial and thin-layer sagittal DWI examination after admission.Those who could not make a definite diagnosis were confirmed by DWI reexamination before discharge.The numbers of positive and negative cases of brainstem infarction at different sites detected by conventional axial and conventional axial+thin-layer sagittal DWI were recorded.Results A total of 65 patients with ABI were included.Conventional axial DWI was positive in 51 patients(78.5%)and was negative in 14(21.5%);conventional axial+thin-layer sagittal DWI were positive in 60 patients(92.3%)and was negative in 5(7.7%).In 8 patients with medullary infarction,only 4(50.0%)were positive on conventional axial DWI,and 6(75.0%)were positive on conventional axial+thin-layer sagittal DWI;in 50 patients with pontine infarction,only 44(88.0%)were positive on conventional axial DWI,and 48(96.0%)were positive on conventional axial+thin-layer sagittal DWI;in 4 patients with midbrain infarction,only 1(25.0%)was positive on conventional axial DWI,and 3(75.0%)were positive on conventional axial+thin-layer sagittal DWI;in 3 patients with pontine+midbrain infarction,only 2(66.7%)were positive on conventional axial DWI,and 3(100.0%)were positive on conventional axial DWI+thin-layer sagittal DWI.The detection rate of ABI on conventional axial+thin-layer sagittal DWI was significantly higher than that on conventional axial DWI,and difference was statistically significant(92.3%vs.78.5%;χ2=4.993,P=0.026).Conclusion The combination of conventional axial and thin-layer sagittal DWI improved the detection rate of ABI.For ABI patients whose axial DWI did not find lesions or whose diag

关 键 词：脑干梗死 脑干 弥散磁共振成像 

分 类 号：R743.33[医药卫生—神经病学与精神病学]