磁敏感成像在颅内微小出血诊断中的应用探讨

SWI in the disagnosis of subtle intracerebral hemorrhage

目的探讨3D-FFE SWI序列对于颅内微小出血的诊断价值。方法对24例临床可疑有颅内少量出血,而常规快速自旋回波(TSE)、液体抑制反转恢复序列(FLAIR)及Gd-DTPA增强扫描未发现明确颅内出血灶者,进行前瞻性的SWI序列扫描。结果对24例中经临床及手术病理证实的19例颅内微小出血,SWI序列均得到明确显示,表现为点状、条状、类圆形或环形的低信号影,其中12例海绵状血管瘤均表现出典型的低信号环("铁环征"),3例急性脑梗死合并少量渗血表现为"扇形"梗死灶中的"点状"低信号出血灶。常规TSE序列和液体抑制反转恢复序列(FLAIR)分别检出其中11例、10例。结论SWI序列对颅内微小出血的敏感性高于常规TSE序列和液体抑制反转恢复序列(FLAIR)。

Objective To investigate the role of magnetic resonance （MR） three-dimensional fast field echo susceptibilityweighted imaging （3D-FFE SWI） in the detection of subtle intracerebral hemorrhage. Methods Twenty-four cases clinically suspected of having intracerebral hemorrhage had undergone conventional MR and SWI sequence. The ability to detect hemorrhage was compared among TSE, FLAIR and SWI sequence. Results Ninteen patients were confirmed by surgical pathology. SWI showed the evidence of hemorrhage in all 19 cases, compared to 11 cases with spin echo TSE, and 10 cases with FLAIR. On SWI, the hemorrhage in the leisons manifested dotty, streak, ovoid, circular areas with hypointensisty signal. Typical circular hypo-intensity signal around the leisions was found in 12 cases of cavernous angioma. Dotty hypo-intensity signal appeared in the wedge-shape infarction lesions in 3 cases of acute brain infarction complicated with little hemorrhagic exudation. Conclusion SWI is superior to the conventional TSE and FLAIR for visualizing subtle intracerebral hemorrhage.