参数优化磁敏感加权成像对急性缺血性脑卒中的诊断价值  

Diagnostic value of parameter-optimized susceptibility-weighted imaging in acute ischemic stroke

作　　者：谭莉平[1] 吴芳[1] 薛翔文 黄家梧 TAN Liping;WU Fang;XUE Xiangwen;HUANG Jiawu(Guangxi Zhuang Autonomous Region Ethnic Hospital,Nanning 530001,China)

机构地区：[1]广西壮族自治区民族医院,广西南宁530001

出　　处：《中国实用神经疾病杂志》2025年第3期271-276,共6页Chinese Journal of Practical Nervous Diseases

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20200007);崇左市科技计划项目(编号:崇科攻2020021)。

摘　　要：目的探讨参数优化磁敏感加权成像(SWI)在急性缺血性脑卒中(AIS)的诊断价值。方法收集2020-01—2023-12在广西壮族自治区民族医院就诊符合入组的60例AIS患者的影像学资料,均采用2种参数进行SWI检查并获得2组影像,常规参数序列为对照组,参数优化序列为实验组,比较2组患者图像的重要征象检出率、扫描时间、图像质量。结果2组患者检出存在CMBs阳性39例,均显示脑内出血灶92个,其中梗死灶内出血转化灶(HT)18个,梗死灶外的微出血灶(CMBs)74个。2组均显示磁敏感血管征(SVS)9例,与MRA显示血管闭塞部位一致。2组均显示突出血管征(PVS)23例,与三维动脉自旋标记(3D-ASL)显示低灌注区一致。对照组扫描时间294 s,实验组为145 s。实验组图像质量评分(3.27±0.15)分,对照组为(3.65±0.25)分,差异有统计学意义(P<0.05),但实验组评分均>3分,图像质量满足诊断要求。结论SWI是很有价值的成像序列,可提供有关AIS患者的重要补充信息,识别具有预后价值并影响治疗决策的各种影像特征,经参数优化的SWI仅需145 s即可执行,可纳入AIS患者急诊检查的MRI成像序列。Objective To investigate the diagnostic value of parameter-optimized susceptibility-weighted imaging(SWI)in acute ischemic stroke(AIS).Methods Sixty AIS patients who met the inclusion criteria and were treated in Guangxi Zhuang Autonomous Region Ethnic Hospital from January 2020 to December 2023 were collected.Each patient underwent SWI examination with two sets of parameters and obtained two sets of images.The conventional parameter sequence was the control group,and the parameter-optimized sequence was the experimental group.The detection rate of important signs,scanning time,and image quality of the two groups of images were compared.Results Thirty-nine patients with positive CMBs were detected in both groups,showing 92 intracerebral hemorrhage foci,including 18 hemorrhage transformed(HT)foci within infarction foci,and 74 cerebral microbleeds(CMBs)foci outside the infarction foci.Nine cases of magnetically susceptibility vascular sign(SVS)were detected in both groups,which was in line with the site of vascular occlusion shown by MRA.Twenty-three cases of prominent vessel sign(PVS)were detected in both groups,which was in line with the area of hypoperfusion shown by three-dimensional arterial spin labeling(3D-ASL)showing hypoperfusion areas.The scanning time of the control group was 294 s,and that of the experimental group was 145 s.The image quality score of the experimental group was 3.27±0.15,which of the control group was 3.65±0.25,and the difference was statistically significant(P<0.05),but the scores of the experimental group were all higher than 3,and the image quality met the diagnostic requirements.Conclusion SWI is a very valuable imaging sequence,which can provide important complementary information about AIS patients,and can identify various imaging features with prognostic value and affecting treatment decisions.The SWI optimized by parameters can be performed in only 145 s and can be included in the MRI imaging sequence of emergency examination of AIS patients.

关 键 词：缺血性脑卒中 磁共振成像 磁敏感加权成像 参数优化 出血转化灶 微出血灶 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]