3.0TMRI诊断高血压性脑微出血的价值

The value of various MRI sequences for detection of cerebral microbleeds in hypertensive patients

目的比较MRI不同扫描序列检出高血压性脑微出血（CMBs）的能力。方法对215例高血压患者行颅脑常规MRI和梯度回波T2^＊加权（GRE T2^＊-WI）扫描，并对其中的21例行磁敏感加权成像（SWI）扫描，比较不同扫描序列检出CMBs的差异，以及分析CMBs在GRE T2^＊-WI上的分布。结果215例患者中，GRE T2^＊-WI检出的CMBs最多（112例，961个CMBs），其次为T2WI、DWI、T2 Flair和T1WI。在GRE T2^＊-WI上，脑不同部位CMBs的分布不同，以皮质-皮质下区最多，小脑最少。21例行SWI的患者中，SWI检出267个CMBs。结论在MRI检出高血压患者CMBs方面，GRE T2^＊-WI序列应作为首选，SWI是检出CMBs的辅助检查方法。

Objective To compare the detectability of cerebral microbleeds （CMBs） in hypertensive patients in different MR pulse sequences and analyze the topography of CMBs visualized on gradient echo T2 ^＊ -weighted imaging （GRE T2^＊ - WI）. Methods Two hundred and Fifteen hypertensive patients （ 117 men and 98 women, （69.07 ± 8.20） years old） were examined at 3.0T by using conventional and GRE T2^＊ -WI sequences to detect numbers of CMBs. The numbers was compared among the sequences. The locations of the CMBs were categorized by cerebral region （cortico-subcortical, basal ganglia, thalamus, brain stem and cerebellum ） on GRE T2^＊-WI. Of the 215 patients, 21 were examined by using the susceptibility weighted imaging （SWI）. Results Of the 215 hypertensive patients, the median of CMBs detected were 2 on TIWI（range,1 to 9）, 2 （1 to 18） on T2WI, 2 （1 to 13）on T2Flair, 2 （1 to 15） on DWI, and 2.5 （ 1 to 91 ） on GRE T2^＊ -WI, respectively. The number of CMBs on GRE T2^＊ -WI was significantly higher than that on the conventional MR sequences. On GRE T2^＊ -WI, the numbers of CMBs was significantly higher in the cortico-subcortical region than in any of the other regions. The cerebellum had the lowest numbers of CMBs among all the regions examined. In 21 cases, 267 and 215 CMBs were detected on SWI and GRE T2^＊ -WI in the same coverage, respectively. Conclusions GRE T2^＊ -WI could be the first choice of MR imaging sequence in diagnosing CMBs in hypertensive patients, with SWI as a supplementary one.