磁共振检测脑出血的敏感性及梗死后T1高信号病例分析

The sensitivity of MR imaging detecting cerebral hemorrhage and the analysis of ischemic hyperintensity on TlWI

目的评价磁共振序列检测脑出血的敏感性,鉴别及分析梗死后T1WI高信号病例。方法33位磁共振常规序列怀疑、不能除外脑出血的患者分别追加磁共振FFE T*2WI及CT扫描。判别不同磁共振序列及CT对脑出血的诊断价值。并且对梗死后短T1病例进行鉴别及分析。结果28例为经CT或病史确诊为脑出血,所有出血病例在FFE T*2WI上的表现为:血肿周围区呈现清晰的低信号带,5例为非出血病例,T1WI呈现高信号,FFE T*2WI无颅内出血的低信号表现,与CT结果一致。产生梗死后T1高信号的病变可包括:不完全性脑梗死和皮质层状坏死。结论FFE T*2WI可以敏感的检测到脑出血并排除T1高信号的假阳性出血病例,与常规磁共振序列组合可以进行较为正确的临床分期。

Objective To investigate the susceptibility of MR imaging detecting cerebral hemorrhage and analyze the mechanism of ischemic hyperintensity on TlWI. Methods 33 patients suspicious of crebral hemorrhage with MRI routine sequences performed FFE T^2WI and CT scan. To evaluate the diagnostic value of MRI sequences and CT scan for cerebral hemorrhage and analyze the mechanism of ischemic hyperintensity on TlWI. Result 28 patients were cerebral hemorrhage with CT or medical record. The specific appearance of all the haematomas on FFE T^2WI: hypointensity/isointensity/hyperintensity bulk surrounded by a marked hypointensity rim. 5 patients with high signal on TlWI were not cerebral hemorrhage in whom there were not corresponding hemcrrhagic transformation on FFE T2WI. The result was identical to that on CT. The neuropathology of ischemic hyperintensity included two forms: incomplete infarction and cortical laminar necrosis. Conclusion FFE T^2WI can detect cerebral hemorrhage and exclude the ischemic hyperintensity on TIWI. FFE T^2WI combined with the routine MRI sequences can estimate the age of lesion correctly.