3.0 T磁共振弥散加权成像在脑部病变诊断中的应用价值  

Application value of 3.0 T magnetic resonance diffusion weighted imaging in diagnosis of brain lesions

作　　者：荆彦平[1] 骆宾[1] 郭振安 徐雯静 荆怡玟 王茹茹 郭克锋[2] 冀晓楠 Jing Yanping;Luo Bin;Guo Zheng′an;Xu Wenjing;Jing Yiwen;Wang Ruru;Guo Kefeng;Ji Xiaonan(Image Center,the Affiliate Huanghe Sanmenxia Hospital of Henan University of Science and Technology,Sanmenxia 472000,China;不详)

机构地区：[1]河南科技大学附属黄河三门峡医院影像中心,472000 [2]河南科技大学附属黄河三门峡医院肿瘤科,472000

出　　处：《实用医学影像杂志》2022年第2期128-131,共4页Journal of Practical Medical Imaging

基　　金：中国电建集团医疗健康产业基金项目(2021009)。

摘　　要：目的探讨3.0 T磁共振弥散加权成像(DWI)在脑部病变的诊断价值。方法对临床证实的62例脑部病变患者磁共振成像(MRI)常规平扫、DWI及表观弥散系数(ADC)值进行回顾性分析,所有病例均采用T1WI、T2WI、T2flair序列、单次激发自旋回波-回波平面成像(SE-EPI)序列行DWI扫描,弥散敏感系数(b值)取1000 s/mm2。结果62例病变中,脑梗死35例,脑出血12例,脑脓肿2例,脑膜瘤5例,脑转移瘤4例,脑脱髓鞘病变4例;DWI对急性、超急性脑梗死高度敏感,呈高信号;对急性脑出血也很敏感,呈低信号;对脑脓肿的诊断有特异性,脓腔呈明显弥散受限高信号;对脑膜瘤、脑转移瘤的敏感性稍低,部分弥散不受限;在脑脱髓鞘病变弥散不受限。急性或亚急性脑梗死、脑脓肿、脑转移瘤的ADC值较低。MRI平扫诊断上述病变的灵敏度为88.9%(24/27),特异性为88.6%(31/35),准确度为88.7%(55/62);MRI平扫联合DWI诊断上述病变的灵敏度为92.9%(26/28),特异度为94.1%(32/34),准确度为93.5%(58/62)。结论DWI在脑部病变的诊断有重要价值;MRI平扫联合DWI成像能明显提高脑部病变诊断准确性,DWI应作为脑部病变的必扫序列。Objective To study the diagnostic value of 3.0 T magnetic resonance diffusion weighted imaging in brain lesions.Methods In the 62 cases of brain lesions proved by clinic were retrospectively analyzed.Examined routine MRI scan,DWI and apparent diffusion coefficient value(ADC),preoperatively,all cases using T1WI、T2WI、T2flair,single excitation echo plane-spin imaging(SE-EPI)to DWI scans,spread sensitive coefficient was(b)1000 s/mm2.Results Among the 62 cases,35 cases was cerebral infarction,12 cases of cerebral hemorrhage,2 cases of brain abscess,5 cases of meningioma,4 cases of brain metastasis and 4 cases of brain demyelination.DWI was highly sensitive to acute and hyperacute cerebral infarction and showed high signal.It is also sensitive to acute cerebral hemorrhage with low signal.The diagnosis of brain abscess was specific and the abscess cavity showed obvious high signal of limited diffusion.The sensitivity to meningioma and brain metastases was slightly lower,and some of them spread unrestricted.The diffusion of demyelinating lesions in the brain is not limited.ADC values of acute or subacute cerebral infarction,brain abscess and brain metastases were lower.The sensitivity,specificity and accuracy of MRI plain scan were 88.9%(24/27),88.6%(31/35)and 88.7%(55/62)respectively.The sensitivity,specificity and accuracy of MRI plain scan combined with DWI were 92.9%(26/28),94.1%(32/34)and 93.5%(58/62)respectively.Conclusion DWI plays an important role in the diagnosis of brain lesions.MRI plain scan combined with DWI imaging can significantly improve the diagnostic accuracy of brain lesions,and DWI should be used as the necessary sequence of brain lesions.

关 键 词：脑部病变 磁共振成像 扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R741[医药卫生—诊断学]