磁共振在脑梗死诊断及高压氧治疗中的应用  

Application of magnetic resonance imaging in cerebral infarction diagnosis and hyperbaric oxygen therapy

作　　者：陈琪璇 黄文起[1] 郭炳伦[1] Chen Qixuan;Huang Wenqi;Guo Binglun(Department of MRI,First People's Hospital of Shangqiu,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院核磁室,商丘476000

出　　处：《中华航海医学与高气压医学杂志》2022年第4期542-545,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191496)。

摘　　要：目的:探讨核磁共振(MRI)弥散加权成像(DWI)中的表观弥散系数(ADC)值对脑梗死的诊断价值,同时运用ADC值评估高压氧治疗脑梗死的疗效。方法:选取2019年5月至2021年4月在商丘市第一人民医院接受诊疗的脑梗死患者180例,按照随机数字表法分为观察组和对照组,每组90例。对照组给予常规治疗,观察组在对照组的治疗基础上辅助高压氧治疗。比较常规MRI与DWI检查对不同分期脑梗死患者的检出率;观察不同分期脑梗死患者病灶的DWI影像特征;比较观察组和对照组患者的美国国立卫生院卒中量表(NIHSS)评分及ADC值;分析ADC值与NIHSS评分的相关性。结果:DWI检查对急性期与超急性期脑梗死患者的检出率显著高于常规MRI检查(P<0.05);不同分期患者的病灶最长径及ADC值比较,亚急性期>急性期>超急性期,差异均有统计学意义(P<0.05);治疗后NIHSS评分观察组显著低于对照组,ADC值观察组显著高于对照组(P<0.05);ADC值与NIHSS评分存在负相关(P<0.05)。结论:MRI-DWI检查对急性期与超急性期脑梗死诊断效能显著优于常规MRI检查,ADC值可反映脑组织的生理病理情况,并评估高压氧的治疗效果。Objective To explore the value of apparent diffusion coefficient(ADC)of diffusion-weighted imaging(DWI),an addition to conventional nuclear magnetic resonance imaging(MRI),in diagnosing cerebral infarction,and to evaluate the curative effect of hyperbaric oxygen(HBO)on cerebral infarction by using ADC value.Methods A total of 180 patients with cerebral infarction who were diagnosed and treated in the First People’s Hospital of Shangqiu from May 2019 to April 2021 were selected and divided into observation group and control group by using the random number table method,with 90 cases in each group.The control group was given conventional treatment,while the observation group was given HBO therapy on the basis of the treatment of the control group.The detection rates of conventional MRI and DWI on patients with different stages of cerebral infarction were compared.The DWI imaging characteristics of lesions in patients with different stages of cerebral infarction were observed.The National Institutes of Health Stroke Scale(NIHSS)scores and ADC values between the two group were compared,and the correlation between ADC value and NIHSS score was analyzed.Results The detection rate of DWI in patients with acute and hyperacute cerebral infarction was significantly higher than that of conventional MRI(P<0.05);the longest diameters and ADC values of lesions in patients with different stages of cerebral infarction were compared,and the results were subacute>acute>hyperacute,and the differences were statistically significant(P<0.05);after treatment,the NIHSS scores of the observation group were significantly lower than those of the control group(P<0.05);the ADC values of the observation group were significantly higher than those of the control group(P<0.05);and there was a negative correlation between ADC values and NIHSS scores(P<0.05).Conclusion MRI-DWI is significantly better than conventional MRI in diagnosing acute and hyperacute cerebral infarction.The ADC values reflect the physiological and pathological conditions o

关 键 词：核磁共振 弥散加权成像 脑梗死 高压氧 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]