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【摘要】 目的 探讨低场强(0.2T)磁共振线扫描弥散成像在早期脑缺血中的诊断价值。方法 搜集并回顾性对比分析过去1年内最终确诊的早期脑缺血患者(发病时间在24h以内)40例及一过性脑缺血患者2例的低场强磁共振线扫描弥散加权成像(LSDI)图像、T1WI图像、T2WI图像;所有病例均以24h以后复查的MRI为确诊依据。根据发病时间将早期脑缺血患者分为四组。发病时间在0~3h以内4例为第一组;发病时间在3~6h以内9例为第二组;发病时间在6~12h以内13例为第三组;发病时间在12~24h以内14例为第四组。结果 (1)42例患者中,第一组发病0~3h以内的患者共4例,T1WI、T2WI均无异常信号,1例LSDI出现略高信号,占25%。T1WI、T2WI与LSDI信号出现率之间差异有非常显著性(P<0.01)。(2)第二组发病3~6h的患者共9例,T2WI出现高信号的2例,占22%;LSDI出现略高信号的6例,占67%。T1WI、T2WI与LSDI信号出现率之间差异有显著性(P<0.05)。(3)第三组发病6~12h的患者13例,T1WI出现略低信号的2例,占15%,T2WI出现高信号的7例,占54%;LSDI见高信号的12例,占92%。T1WI、T2WI与LSDI信号出现率之间差异有显著性(P<0.05)。(4)第四组发病12~24h的患者14例,T1WI出现低信号的10例,占71%,T2WI、LSDI均见高信号的13例,占93%。T1WI、T2WI与LSDI信号出现率之间差异无显著性(P>0.05)。另外最后确诊为一过性脑缺血患者2例,检查时间分别为发病后14和20h,LSDI、T1WI、T2WI均未见异常信号。结论 在早期脑缺血的诊断中,低场强(0.2T)磁共振线扫描弥散成像比T1WI、T2WI平扫发现病变早,对于发现病变、确定病变部位、病变大小具有较高的价值,可为临床早期治疗提供可靠的诊断依据。
【关键词】 磁共振成像,弥散,脑缺血,早期诊断
The value of low magnetic field intensity MR line scan diffusion-weighted imaging in the diagnosis of cerebral ischemia in early stage
【Abstract】 Objective To evaluate the value of low magnetic-field intensity MR line scan diffusion-weighted imaging(LSDI)in the diagnosis of cerebral ischemia in early stage.Methods LSDI、T1-weighted imaging(T1WI)、T2-weighted imaging(T2WI)were performed in 42 patients confirmed with cerebral ischemia in the early stage(≤24h) in last year,and the images taken from different sequences were compared.To make sure the right rate of diagnosis,the follow-up examination after 24 hours were performed on all the patients and the positive diagnosis were ensured.42 patients were allocated to one of the four groups according to the different interval between scanning and attack.The interval of group one is within 0~3 hours,group two within 3~6 hours,group three within 6~12 hours and group four within 12~24 hours.Results (1)There were 4 patients in group one(all within 3 hours)presented with normal findings of T1WI and T2WI and with light high signal in 1 patient''s LSDI(25%);(2)There were 9 patients in group two,high signal were found in 2 patient''s T2WI(22%)and in 6 patient''s LSDI(67%);(3)There were 13 patients in group three,light low signal were found in 2 patient''s T1WI(15%)and high signal in 7 patient''s T2WI(54%)and in 12 patient''s LSDI(91%);(4)There were 14 patients in group four,long T1 signal were found in 10 patient''s T1WI(68%);high signal were found in all patient''s in this group on T2WI and LSDI(100%).Two patients with transient cerbral ischemia whose examinations were performed after 14 hours and 20 hours were also selected,the findings on LSDI,T1WI and T2WI were all negtive.Conclusion Low magnetic-field intensity LSDI sequence is more sensitive than routin scan for the diagnosis of cerebral ischemia and ensure the location and size of lesion in early stage.It can give useful information for clinical treatment.
【Key words】 diffusion magnetic resonance imaging;brain ischemia;early diagnosis
目录:
1 资料与方法
2 结果
3 讨论
参考文献:
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