高场强MRI扫描DWI联合SWI序列在急性期脑出血诊断中的应用价值分析

Value of High Field Intensity MRI DWI Combined with SWI Sequence in the Diagnosis of Acute Cerebral Hemorrhage

目的探讨高场强MRI扫描DWI联合SWI序列在急性期脑出血诊断中的应用价值。方法选取我院2016年1月-2017年12月收治的脑出血患者59例,均进行了多序列MRI检查,对DWI及SWI上急性期脑出血表现特征进行总结。结果59例急性期脑出血共76个病灶,DWI序列诊断急性期脑出血的敏感度、准确率分别为64.47%、69.73%,SWI序列诊断急性期脑出血的敏感度、准确率分别为84.21%、80.26%,SWI+DWI序列诊断急性期脑出血的敏感度、准确率分别为100.00%、98.68%,SWI+DWI序列诊断急性期脑出血的敏感度、准确率明显高于单一SWI、DWI序列,差异有统计学意义(P<0.05)。T1WI序列急性期出血病灶主要表现为低信号或等信号,呈斑点状,最大出血点总面积120mm2;T2WI上病灶呈现低信号,12例患者可见周边高信号水肿带,相对较窄,最大出血点总面积210mm2;FLAIR序列呈低信号,最大出血点总面积245mm2;SWI血肿区域呈现低信号,血肿周围呈高信号,边界清晰,最大出血点总面积330mm2;DWI序列中,多数患者呈现混杂信号,血肿周围存在高信号,中央为极低信号,边缘信号呈线状中心信号极低,最大出血点总面积284mm2。结论高场强MRI DWI联合SWI序列均可有效显示急性期脑出血患者图像表现,DWI联合SWI序列诊断急性期脑出血敏感度、准确率高。

Objective To explore the value of high field intensity MRI DWI combined with SWI sequence in the diagnosis of acute cerebral hemorrhage.Methods A total of 59 patients with cerebral hemorrhage admitted to our hospital from January 2016 to December 2017 were examined by multi-sequence MRI.The scanning sequence included T1WI,T2WI,fluid attenuated inversion recovery(FLAIR),diffusion weighted imaging(DWI),and susceptibility weighted imaging(SWI).The sensitivity and accuracy of different scanning sequences in the diagnosis of acute cerebral hemorrhage were compared.Results There were 76 lesions in 59 patients with acute cerebral hemorrhage.The sensitivity and accuracy of DWI sequence in the diagnosis of acute cerebral hemorrhage were 64.47%and 69.73%,respectively.The sensitivity and accuracy of SWI sequence in the diagnosis of acute cerebral hemorrhage were 84.21%and 80.26%,respectively.The sensitivity and accuracy of SWI+DWI sequence in the diagnosis of acute cerebral hemorrhage were 100.00%and 98.68%,respectively.The sensitivity and accuracy of SWI+DWI sequence in the diagnosis of acute cerebral hemorrhage were significantly higher than those of single SWI and DWI sequence(P<0.05).The lesions of T1WI sequence mainly showed low or iso-signal,and the bleeding spots were spotted.The total area of the largest bleeding spots was 120 mm2.The lesions showed low signal on T2WI,and 12 patients showed peripheral high signal edema zone,which was relatively narrow.The total area of maximum bleeding point was 210 mm2.FLAIR sequence showed low signal,the maximum area of bleeding point was 245 mm2.SWI hematoma area showed low signal,high signal around the hematoma,clear boundary,the total area of the largest bleeding point was 330 mm2;DWI sequence showed mixed signal,high signal around the hematoma,very low signal in the center,low signal in the edge,and 284 mm2 in the total area of the largest bleeding point.Conclusion High field intensity MRI DWI combined with SWI sequence demonstrated the image manifestations of acute cerebral hemorrhage effectively.DWI combined with SWI sequence has high sensitivity and accuracy in the diagnosis of acute cerebral hemorrhage.