磁敏感加权成像对脑梗死的诊断价值

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1、磁敏感加权成像对脑梗死的诊断价值郭大静，陈维娟，吴伟，张维，罗银灯，赵建农（重庆医科大学附属第二医院放射科，重庆400010）摘要：目的探讨磁敏感加权成像（SWI）对脑梗死的诊断价值。方法搜集经临床及影像学检查证实的脑梗死患者38例，急性期15例，亚急性期17例，慢性期脑软化灶6例。所有患者均行常规T1WI，T2WI，T2FLAIR平扫、DWI及SWI扫描，其中25例行MRA检查。分析MRI图像特点。结果常规MRI检出脑梗死灶内出血5例18个出血灶，SWI检出脑梗死灶内出血11例62个出血灶（P＜0.05）。急性期15例脑梗死灶SWI图像均表现为等信号，亚急性期11例为等信号，

2、6例为低信号，慢性期6例均为低信号，不同时期脑梗死灶SWI信号特点差异有统计学意义（P＜0.05）。急性期15例脑梗死灶内小静脉明显减少，亚急性期9例脑梗死灶内小静脉减少，8例脑梗死灶内小静脉及邻近脑组织内血管较对侧增多扭曲，慢性期6例脑软化灶内均可见增粗迂曲血管影，不同时期脑梗死灶内静脉血管的显示差异有统计学意义（P＜0.05)。MRA显示17例患者一侧大脑中动脉闭塞，SWI均显示闭塞大脑中动脉内的血栓。结论SWI在显示脑梗死并发出血、脑梗死后血管构建等方面优于常规MRI序列，和常规MRI序列结合对脑梗死的诊断更为准确、全面，有重要的临床应用价值。关键词：磁敏感加权成像；磁共

3、振；脑梗死中图法分类号：R816.1文献标识码：ADiagnosticvalueofsusceptibilityweightedimagingincerebralinfarctionGUODa-jing,CHENWei-juan,WUWei,ZHANGWei,LUOYin-Deng,ZHAOJian-nong（DepartmentofRadiology，theSecondAffiliatedHospital，ChongqingMedicalUniversity,Chongqing400010,China）Abstract：ObjectiveToinvestigatethedia

4、gnosticvalueofsusceptibilityweightedimaging(SWI)incerebralinfarction.MethodsThirty-eightpatientswithclinicalorradiologicalprovedcerebralinfarctionwereenrolledinthisstudyincluding15acutecerebralinfarctioncases,17subacutecerebralinfarctioncasesand6chroniccerebralinfarctioncaseswithencephalamal

5、acia.Conventionalnon-contrastsequencesincludingT1WI，T2WI，T2FLAIR,diffusionweightedimaging(DWI)andSWIwereperformedinallpatients,and25patientsunderwentMRA.Characteristicsofimageswereanalyzed.Results18hemorrhagiclesionswithininfarctionweredetectedin5patientsbyroutinesequences,whileSWIshowed62he

6、morrhagiclesionswithininfarctionin11patients(p＜0.05).OnSWI,acutecerebralinfarctionappearedisointensityinall15cases,subacuteinfarctiondisplayedisointensity(11cases)andhypointensity(6cases),andallchronicinfarction(6cases)demonstratedhypointensity.Theintensitydifferenceindifferentstageshasstati

7、sticalsignificance(p＜0.05).SWIfoundreducedvenulainsidetheinfarctedareasinall15acutecases.Itrevealedreducedvenula(9cases)andincreasedandtortuousvenula(8cases)insubacuteinfarctionwhencomparedwiththeunaffectedside.Thickenedandtortuousvesselscanbeseeni