MR扩散加权成像信号特征在急性缺血性脑卒中中的应用研究  

Application Study on MR DWI Signal Characteristic in Acute Ischemic Stroke

作　　者：张宁 张金平[2] 姚宜斌 汤永祥[2] 丁红梅 胡章明 李石坚[2] 张冉[2] Zhang Ning;Zhang Jinping;Yao Yibin;Tang Yongxiang;Ding Hongmei;Hu Zhangming;Li Shijian;Zhang Ran(Graduate School,Wannan Medical College,Wuhu,Anhui 241000;Medical Imaging Center,Tongling People’s Hospital Affiliated to Wannan Medical College,Tongling,Anhui 244000;Department of Science and Education,Tongling People’s Hospital Affiliated to Wannan Medical College,Tongling,Anhui 244000)

机构地区：[1]安徽省皖南医学院研究生学院,安徽芜湖241000 [2]安徽省皖南医学院附属铜陵市人民医院医学影像中心,安徽铜陵244000 [3]安徽省皖南医学院附属铜陵市人民医院科教处,安徽铜陵244000

出　　处：《现代医用影像学》2023年第1期45-52,共8页Modern Medical Imageology

摘　　要：目的:研究急性单发脑梗死患者首次磁共振扩散加权成像(DWI)病灶信号强度在急性脑梗死分期中的应用价值,并探讨病灶信号均质度对评估患者入院病情严重程度的价值。方法:回顾性对符合入选条件的177例前循环急性脑梗死患者,通过测得整体病灶相对信号强度(relative signal intensity,rSI)作为观察指标,统计分析超急性期、急性期和亚急性早期3组之间病灶rSI是否存在差异性;分析患者总体症状发作与首次急诊入院DWI检查的间隔时间与相应rSI的相关性;采用联合rSI的综合评分法对病灶均质与非均质进行评定,把病灶信号均质组与非均质组相应的入院NIHSS评分高低四组总体分布进行比较,并进行统计学分析。结果:177例中超急性期组24例、急性期组78例及亚急性早期组75例;轻度卒中组90例、中度卒中组66例、中-重度卒中组14例及重度卒中组7例。超急性脑梗死组rSI(1.573±0.238)、急性脑梗死组rSI(1.751±0.227)及亚急性早期脑梗死组rSI(1.943±0.309),三者相互之间均有统计学差异,所有P<0.01;177例rSI与相应的症状发作与首次急诊入院DWI检查的间隔时间呈正相关(r=0.553,P<0.01);信号均质病灶组103例,信号非均质病灶组74例,两组在入院NIHSS评分高低组别总体分布有统计学意义(P<0.05),且均质组和非均质病灶组病情程度分组总体概率分布不同,均质组中轻度组出现频率高于非均质组,非均质组中中度组出现的频率高于均质组。结论:首次DWI成像的对前循环单发急性脑梗死病灶信号强度测量,有利于总体上急性脑梗死超急性期、急性期及亚急性早期的临床分期;非均质病灶患者总体上较均质病灶患者的临床病情严重程度为重,病灶均质度判定对评估临床病情严重趋势具有一定价值。Objective:To study the application value of the first DWI signal intensity in the staging of acute cerebral infarction in patients with single acute cerebral infarction,and to explore the value of signal homogeneity in assessing the clincial severity of the patient’s admission to the hospital.Methods:The first DWI for 177 patients with acute cerebral infarction in the anterior circulation were retrospectively studied.The relative signal intensity(rSI)of the overall lesion was measured as an observation index,and the rSI in the hyperacute phase,acute phase or early subacute phase was statistically analyzed.The correlation between the first symptom onset time and the corresponding rSI in all patients was analysed.The comprehensive scoring method combined with rSI was used to evaluate the homogeneity and heterogeneity of lesions.The overall distribution of the corresponding NIHSS score level groups at admission was compared between the homogeneous group and the heterogeneous group,and was statistical analysed.Results:There were 24 cases in the hyperacute phase group,78 cases in the acute phase group and 75 cases in the early subacute phase group;90 cases in the mild stroke group,66 cases in the moderate stroke group,14 cases in the moderate-severe stroke group,and 7 cases in the severe stroke group.The rSI in the hyperacute cerebral infarction group,in the acute cerebral infarction group and in the early subacute cerebral infarction group were(1.573±0.238),(1.751±0.227)and(1.943±0.309)respectively,and there are statistical significant differences among the three(all P<0.01);177 cases of rSI were positively correlated with the corresponding first symptom onset time(r=0.553,P<0.01).There were 103 cases in the signal homogeneous lesion group and 74 cases in the signal heterogeneity group,the distribution of the two groups in the different NIHSS score level groups was statistically significant(P<0.05).The overall probability distribution of clinical severity was different between homogeneous group and heterogeneous

关 键 词：磁共振扩散加权成像 信号特征 缺血性脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]