标准化磁共振DWI及灌注加权成像对不同时期脑梗死临床诊断的应用价值研究  

Application Value of Standardized Magnetic Resonance DWI and Perfusion Weighted Imaging in the Clinical Diagnosis of Cerebral Infarction in Different Periods

作　　者：王晓燕 韩金花 WANG Xiao-yan;HAN Jin-hua(Medical Imaging Department,Li County First People’s Hospital;Department of Radiology,Qingdao Central Hospital)

机构地区：[1]礼县第一人民医院医学影像科 [2]青岛市中心医院放射科

出　　处：《中国标准化》2024年第16期273-276,共4页China Standardization

摘　　要：目的:探讨标准化磁共振DWI及灌注加权成像对不同时期脑梗死临床诊断的应用价值。方法:选取2023年6月至2024年3月礼县第一人民医院收治的脑梗死者100例行回顾性分析,根据发病时间,分超急性期30例、急性期20例、亚急性期20例和慢性期30例,均予以标准化DWI及PWI(灌注加权成像),观察所得参数差异、PWI与DWI异常区域差异。结果:患侧脑组织在超急性期、急性期,表观弥散系数,比健侧低;而表观弥散系数于亚急性期、慢性期,患侧高于健侧,有统计学差异(P<0.05);在超急性期,患者多为PWI<DWI;急性期,多表现为PWI>DWI;亚急性期、慢性期,以PWI=DWI为主要表现;CBV、CBF超急性期,表现降低,MTT、TTP为延长;MTT、TTP急性期,降低2例,延长16例,CBF、CBV降低12例、13例,延长6例、2例;MTT、TTP亚急性期,6例降低、14例延长,CBF、CBV表现12例降低;慢性期,TTP、MTT以7例降低、23例延长为主,而CBF、CBV则以30例降低为主。结论:不同时期脑梗死者,标准化DWI扫描,能清晰显示出病灶,而标准化PWI,可显示缺血半暗带,两者合用,能够反映不同时间窗下脑组织的血流状态。TObjective:To evaluate the clinical value of standardized magnetic resonance DWI and perfusion weighted imaging in the diagnosis of cerebral infarction in different periods.Methods:A retrospective analysis was performed on 100 patients with cerebral infarction admitted to the Lixian County First People’s Hospital from June 2023 to March 2024.According to the time of onset,30 cases were divided into superacute stage,20 cases in acute stage,20 cases in subacute stage and 30 cases in chronic stage.Standardized DWI and PWI(perfusion weighted imaging)were applied to all cases.The differences of parameters and abnormal regions between PWI and DWI were observed.Results:The apparent diffusion coefficient of the affected side was lower than that of the healthy side in the hyperacute stage and acute stage.The apparent diffusion coefficient was higher on the affected side than on the healthy side in the subacute stage and chronic stage(P<0.05).In the hyperacute stage,most patients had PWI<DWI;In the acute stage,PWI was more than DWI.In subacute and chronic stages,PWI=DWI was the main manifestation.In the hyperacute stage of CBV and CBF,the manifestations were decreased,while MTT and TTP were prolonged.In the acute stage,MTT and TTP decreased in 2 cases and prolonged in 16 cases,CBF and CBV decreased in 12 cases and 13 cases and prolonged in 6 cases and 2 cases.In the subacute stage,MTT and TTP were decreased in 6 cases,prolonged in 14 cases,and CBF and CBV were decreased in 12 cases.In chronic phase,TTP and MTT were mainly decreased in 7 cases and prolonged in 23 cases,while CBF and CBV were mainly decreased in 30 cases.Conclusion:In patients with cerebral infarction at different periods,the standardized DWI scan can clearly show the lesions,while the standardized PWI shows the convexity ischemic penumbra.The integration of both reflect the blood flow status of brain tissue under different time windows.

关 键 词：脑梗死 灌注加权成像 标准化磁共振DWI 

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]